Division of Neonatology, Rainbow Babies & Children's Hospital, Cleveland, OH, USA.
Early Hum Dev. 2013 Jun;89 Suppl 1:S14-6. doi: 10.1016/S0378-3782(13)70005-7.
Apnea of prematurity and gastroesophageal reflux (GER) are both common occurrences in preterm infants and widely perceived to be causally related. We seek in this review to provide a potential guideline for neonatal GER non-pharmacologic and pharmacologic therapy. Available physiologic data suggest that when there is a temporal relationship apnea may be more likely to predispose to GER via esophageal sphincter relaxation than vice versa. Measurement of multiple intraluminal impedance via esophageal catheter in addition to esophageal pH has enhanced our understanding of GER, although it also did not demonstrate a causal relationship between apnea and GER. The incidence of GER may be modified by thickening feeds and position change without adverse effects. In contrast, pharmacotherapy including acid suppression therapy may have adverse effects and should only be used in infants with clear evidence of clinical benefit.
早产儿呼吸暂停和胃食管反流（GER）在早产儿中均为常见现象，且被广泛认为存在因果关系。我们在此综述中旨在为新生儿 GER 的非药物和药物治疗提供潜在的指导方针。现有的生理学数据表明，当存在时间关系时，呼吸暂停更可能通过食管括约肌松弛而导致 GER，而不是反之亦然。通过食管导管测量多个腔内阻抗以及食管 pH 值增强了我们对 GER 的理解，尽管它也没有证明呼吸暂停和 GER 之间存在因果关系。通过增加喂养物稠度和改变体位可以改变 GER 的发生率，而不会产生不良影响。相比之下，包括抑酸治疗在内的药物治疗可能会产生不良影响，并且仅应在有明确临床获益证据的婴儿中使用。
