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伴有积液的慢性中耳炎患儿的喉咽反流

Laryngopharyngeal Reflux in Children with Chronic Otitis Media with Effusion.

作者信息

Górecka-Tuteja Anna, Jastrzębska Izabela, Składzień Jacek, Fyderek Krzysztof

机构信息

Department of Otolaryngology, Rydygier Memorial Specialistic Hospital, Cracow, Poland.

Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum Jagiellonian University, Cracow, Poland.

出版信息

J Neurogastroenterol Motil. 2016 Jul 30;22(3):452-8. doi: 10.5056/jnm16013.

Abstract

BACKGROUND/AIMS: To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry.

METHODS

Children aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire.

RESULTS

Twenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH < 5.0 and a change in the pH value measured from the initial level at the upper sensor of > 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux.

CONCLUSIONS

LPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease.

摘要

背景/目的:采用24小时多通道腔内阻抗联合双探头(咽部和食管)pH值测定法,评估分泌性中耳炎(OME)患儿的喉咽反流(LPR)和胃食管反流(GER)的特征。

方法

对7至10岁的OME患儿进行24小时多通道腔内阻抗pH值测定。上pH传感器位于食管上括约肌上方1 cm处,下pH传感器置于食管下括约肌上方3至5 cm处。要求家长通过儿科问卷完成胃食管反流症状评估。

结果

共纳入28名儿童;19名(67.9%)儿童检测到LPR。LPR诊断标准为至少有一次食管上发作,pH值<5.0,且上传感器处pH值较初始水平变化>0.2。总共观察到64次发作。对所有LPR发作的评估显示,整个研究中共有246次发作。发现弱酸性发作占相当大的优势(87.8%);酸性发作占6.5%,弱碱性发作达5.7%。10名(35.7%)受试者存在病理性GER。8名儿童检测到酸性GER,其中2名表现为非酸性反流。在LPR阴性患者中,除1例非酸性反流外,未证实有病理性GER。

结论

OME患儿组中经常发现LPR,它可能是这种常见疾病的一个重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd75/4930300/59da9c8103cb/jnm-22-452f1.jpg

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