Soares Ana Cristina Fontenele, de Freitas Carla Lima, de Morais Mauro Batista
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.
Rev Paul Pediatr. 2015 Jan-Mar;33(1):12-8. doi: 10.1016/j.rpped.2014.11.005. Epub 2015 Feb 7.
: To assess the knowledge and practice of pediatricians about infants with physiological reflux and gastroesophageal reflux disease.
: 140 pediatricians were interviewed during two scientific events in 2009 and 2010. The questions referred to two clinical cases of infants. One with symptoms of infant regurgitation (physiological reflux) and another with gastroesophageal reflux disease.
: Among 140 pediatricians, 11.4% (n=16) and 62.1% (n=87) would require investigation tests, respectively for infant regurgitation (physiological reflux) and gastroesophageal reflux disease. A series of upper gastrointestinal exams would be the first requested with a higher frequency. Medication would be prescribed by 18.6% (n=6) in the case of physiological reflux and 87.1% (n=122) in the case of gastroesophageal reflux disease. Prokinetic drugs would be prescribed more frequently than gastric acid secretion inhibitors. Sleeping position would be recommended by 94.2% (n=132) and 92.9% (n=130) of the respondents, respectively for the case of physiological reflux and gastroesophageal reflux disease; however, about half of the respondents would recommend the prone position. Only 10 (7.1%) of the pediatricians would exclude the cow's milk protein from the infants' diet.
: Approaches different from the international guidelines are often considered appropriate, especially when recommending a different position other than the supine and prescription of medication. In turn, the interviews enable us to infer the right capacity of the pediatricians to distinguish physiologic reflux and gastroesophageal reflux disease correctly.
评估儿科医生对生理性反流婴儿和胃食管反流病的认知与实践。
在2009年和2010年的两次学术活动中对140名儿科医生进行访谈。问题涉及两个婴儿临床病例。一个有婴儿反流症状(生理性反流),另一个有胃食管反流病。
在140名儿科医生中,分别有11.4%(n = 16)和62.1%(n = 87)会针对婴儿反流(生理性反流)和胃食管反流病进行检查测试。一系列上消化道检查会更频繁地被首先要求进行。对于生理性反流,18.6%(n = 6)的医生会开药;对于胃食管反流病,87.1%(n = 122)的医生会开药。促动力药物的处方频率高于胃酸分泌抑制剂。分别有94.2%(n = 132)和92.9%(n = 130)的受访者会针对生理性反流和胃食管反流病推荐睡眠姿势;然而,约一半的受访者会推荐俯卧位。只有10名(7.1%)儿科医生会从婴儿饮食中排除牛奶蛋白。
与国际指南不同的方法常常被认为是合适的,尤其是在推荐除仰卧位之外的其他姿势和开药时。反过来,这些访谈使我们能够推断儿科医生正确区分生理性反流和胃食管反流病的能力。