Omari Taher I
Gastroenterology Unit, Children, Youth and Women's Health Services, North Adelaide, Australia.
J Pediatr. 2009 Mar;154(3):374-8. doi: 10.1016/j.jpeds.2008.09.009. Epub 2008 Oct 31.
To characterize esophageal motility during episodes of prolonged apnea in premature infants.
We retrospectively reviewed combined manometric and physiological monitoring studies performed in tube-fed premature infants from 1994 to 2002. Apnea was defined as a respiratory pause of >20 seconds. For each apneic event, pharyngeal swallowing, esophageal motility, and lower esophageal sphincter (LES) pressure were assessed before, during, and after apneic episodes.
Twelve episodes of apnea (duration, 20 to 120 seconds) were identified in 7 infants (34 to 37 weeks postmenstrual age (PMA); study weight, 1950 to 2380 g). During the apneic episodes, swallowing increased (median[interquartile range], 0[0,0], 5[4,7], and 1[0,2] swallows/minute before, during, and after apnea, respectively; P < .05), esophageal pressure wave sequences (PWS) increased (1[0,2], 5[3,6], and 2[1,3] PWS/minute before, during, and after apnea, respectively; P < .05) and LES pressure decreased (16[12,21], 6[5,8], and 27[12,32] mmHg before, during, and after apnea, respectively; P < .05).
In premature infants, apnea is associated with reduced LES tone, potentially increasing the likelihood of reflux occurring after the onset of apnea.
描述早产儿长时间呼吸暂停发作期间的食管动力。
我们回顾性分析了1994年至2002年对经鼻饲的早产儿进行的联合测压和生理监测研究。呼吸暂停定义为呼吸暂停超过20秒。对于每一次呼吸暂停事件，在呼吸暂停发作前、发作期间和发作后评估咽部吞咽、食管动力和食管下括约肌（LES）压力。
在7名婴儿（孕龄34至37周；研究体重1950至2380克）中识别出12次呼吸暂停发作（持续时间20至120秒）。在呼吸暂停发作期间，吞咽增加（中位数[四分位间距]，呼吸暂停前、发作期间和发作后分别为0[0,0]、5[4,7]和1[0,2]次吞咽/分钟；P<.05），食管压力波序列（PWS）增加（分别为1[0,2]、5[3,6]和2[1,3]次PWS/分钟；P<.05），LES压力降低（分别为16[12,21]、6[5,8]和27[12,32]mmHg；P<.05）。
在早产儿中，呼吸暂停与LES张力降低有关，这可能增加呼吸暂停发作后反流发生的可能性。
