From the Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
the Universidade de Pernambuco (UPE), Recife, PE, Brazil.
J Pediatr Gastroenterol Nutr. 2022 Aug 1;75(2):159-165. doi: 10.1097/MPG.0000000000003504. Epub 2022 Jun 1.
This study investigated the occurrence of vomiting and gastric dysmotility in dysphagic children with congenital Zika syndrome (CZS) and assessed possible associations of these findings with the severity of dysphagia and the presence of tube feeding.
Forty-six children with CZS were assessed for dysphagia, and the occurrence of vomiting, dietary volume tolerance <15 mL/kg, and feeding time per meal >30 minutes were evaluated. Gastric antrum ultrasonography was used to detect the frequency of contractions and measure antral areas (at fasting and 15 minutes postprandial), from which the gastric emptying rate (GER) was calculated. Antral ultrasonography findings were compared with those of ten healthy controls. Vomiting and gastric motility were compared between CZS patients according to the severity of dysphagia and the requirement for tube feeding.
Overall, 76% (35/46) of children with CZS had moderate-to-severe dysphagia (MSD), among whom 60% (21/35) were tube fed [MSD tube fed (MSDTF)]. Vomiting occurred in 54% (25/46) of children, whereas dietary volume intolerance and prolonged feeding time were observed in 59% (27/46) and 37% (17/46), respectively, most frequently in MSDTF patients. On ultrasound, 61% (28/46) of children with CZS had no antral contractions, whereas 90% (9/10) of controls did. Compared to healthy controls, GER was eight-fold lower in children with CZS and 60-fold lower in MSDTF children.
In dysphagic children with CZS, vomiting, volume intolerance, and prolonged feeding time were frequent and possibly associated with impaired antral contraction and delayed gastric emptying, especially in cases of severe dysphagia and tube feeding.
本研究旨在调查患有先天性寨卡综合征（CZS）的吞咽困难儿童中呕吐和胃动力障碍的发生情况，并评估这些发现与吞咽困难严重程度和置管喂养的关系。
对 46 例 CZS 患儿进行吞咽困难评估，评估呕吐、饮食量耐受<15ml/kg 和每餐喂养时间>30 分钟的发生情况。采用胃窦超声检查检测收缩频率，并测量空腹和餐后 15 分钟时的胃窦面积，计算胃排空率（GER）。将胃窦超声检查结果与 10 例健康对照组进行比较。根据吞咽困难严重程度和置管喂养要求，比较 CZS 患儿的呕吐和胃动力情况。
总体而言，76%（35/46）的 CZS 患儿存在中重度吞咽困难（MSD），其中 60%（21/35）接受了置管喂养[MSD 置管喂养（MSDTF）]。54%（25/46）的患儿发生呕吐，59%（27/46）存在饮食量不耐受，37%（17/46）存在喂养时间延长，这些情况在 MSDTF 患儿中更为常见。超声检查显示，61%（28/46）的 CZS 患儿胃窦无收缩，而对照组 90%（9/10）的患儿有收缩。与健康对照组相比，CZS 患儿的 GER 降低 8 倍，MSDTF 患儿的 GER 降低 60 倍。
在患有 CZS 的吞咽困难儿童中，呕吐、容量不耐受和喂养时间延长较为常见，可能与胃窦收缩功能障碍和胃排空延迟有关，尤其是在吞咽困难严重和需要置管喂养的情况下。
