Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, Via Massarenti 11, 40138 Bologna, Italy ; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Biomed Res Int. 2013;2013:141967. doi: 10.1155/2013/141967. Epub 2013 Sep 1.
Gastroesophageal reflux (GOR) is very common among preterm infants, due to several physiological mechanisms. Although GOR should not be usually considered a pathological condition, its therapeutic management still represents a controversial issue among neonatologists; pharmacological overtreatment, often unuseful and potentially harmful, is increasingly widespread. Hence, a stepwise approach, firstly promoting conservative strategies such as body positioning, milk thickening, or changes of feeding modalities, should be considered the most advisable choice in preterm infants with GOR. This review focuses on the conservative management of GOR in the preterm population, aiming to provide a complete overview, based on currently available evidence, on potential benefits and adverse effects of nonpharmacological measures. Nonpharmacological management of GOR might represent a useful tool for neonatologists to reduce the use of antireflux medications, which should be limited to selected cases of symptomatic babies.
胃食管反流（GOR）在早产儿中非常常见，这是由于多种生理机制所致。尽管 GOR 通常不应被视为一种病理性疾病，但它的治疗管理仍然是新生儿科医生之间存在争议的问题；过度的药物治疗，往往是无用且潜在有害的，越来越普遍。因此，在患有 GOR 的早产儿中，应首先采用逐步的方法，首先促进保守策略，如体位、奶液增稠或喂养方式的改变，这被认为是最明智的选择。这篇综述重点介绍了早产儿 GOR 的保守管理，旨在根据现有证据，全面概述非药物措施的潜在益处和不良反应。对于新生儿科医生来说，GOR 的非药物管理可能是一种有用的工具，可以减少抗反流药物的使用，而这些药物应仅限于有症状的婴儿的特定病例。
