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英国儿科学会胃肠病、肝病和营养学会动力工作组立场声明:小儿多通道腔内pH阻抗监测——适应证、方法及解读

BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring-indications, methods and interpretation.

作者信息

Mutalib Mohamed, Rawat David, Lindley Keith, Borrelli Osvaldo, Perring Steve, Auth Marcus K H, Thapar Nikhil

机构信息

Paediatric Gastroenterology Department, Evelina London Children's Hospital, London, UK.

Paediatric Gastroenterology Department, Royal London Hospital, London, UK.

出版信息

Frontline Gastroenterol. 2017 Jul;8(3):156-162. doi: 10.1136/flgastro-2016-100796. Epub 2017 Mar 15.

Abstract

BACKGROUND

Combined pH-impedance monitoring has been suggested as the investigation of choice for diagnosing gastro-oesophageal reflux in children. Although it is superior to oesophageal pH monitoring in detecting all types of reflux episodes (acid, weakly acidic and alkaline) with the ability to evaluate symptom association with reflux events, it is still limited by the lack of true paediatric normal value and the high cost involved (equipment and personnel).

OBJECTIVE

To produce a position statement on behalf of the Motility Working Group of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition on the indications and practical application of combined oesophageal pH-impedance monitoring in children.

METHODS

Up-to-date review of available evidence.

RESULTS

This document provides a practical guide to clinician on indications, methods and results interpretation of paediatric multichannel intraluminal impedance pH (MII-pH).

CONCLUSIONS

MII-pH is increasingly used by paediatricians as the diagnostic tool for assessing gastro-oesophageal reflux disease and symptom association. There is wide variation in paediatric practice and a need for standardised practice.

摘要

背景

联合pH阻抗监测已被推荐为诊断儿童胃食管反流的首选检查方法。尽管它在检测所有类型的反流事件(酸性、弱酸性和碱性)以及评估症状与反流事件的相关性方面优于食管pH监测,但它仍然受到缺乏真正的儿科正常值以及相关成本高昂(设备和人员)的限制。

目的

代表英国儿科学会胃肠病学、肝病学和营养运动工作组就联合食管pH阻抗监测在儿童中的适应证和实际应用发表一份立场声明。

方法

对现有证据进行最新综述。

结果

本文档为临床医生提供了关于儿科多通道腔内阻抗pH(MII-pH)监测的适应证、方法和结果解读的实用指南。

结论

儿科医生越来越多地将MII-pH用作评估胃食管反流病和症状相关性的诊断工具。儿科实践存在很大差异,需要标准化的实践。

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本文引用的文献

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Effects of Anesthesia on Pediatric pH Impedance.麻醉对小儿食管pH值-阻抗监测的影响
J Pediatr Gastroenterol Nutr. 2016 Aug;63(2):236-41. doi: 10.1097/MPG.0000000000001098.
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Multichannel intraesophageal impedance pattern of children with aerophagia.吞气症患儿的多通道食管内阻抗模式
Neurogastroenterol Motil. 2014 Jul;26(7):1010-4. doi: 10.1111/nmo.12355. Epub 2014 May 5.
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Esophageal acid exposure decreases intraluminal baseline impedance levels.食管酸暴露会降低腔内基础阻抗水平。
Am J Gastroenterol. 2011 Dec;106(12):2093-7. doi: 10.1038/ajg.2011.276. Epub 2011 Aug 16.
10
Esophageal impedance monitoring for gastroesophageal reflux.食管阻抗监测用于胃食管反流。
J Pediatr Gastroenterol Nutr. 2011 Feb;52(2):129-39. doi: 10.1097/MPG.0b013e3181ffde67.

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