Kuo B, Castell D O
Department of Medicine, Graduate Hospital, Philadelphia, Pennsylvania, USA.
Am J Gastroenterol. 1995 Oct;90(10):1804-7.
Previous reports have revealed conflicting conclusions about whether tubes placed across the esophagogastric junction (EGJ) have promoted reflux and whether there is potential for subsequent esophageal mucosal damage. The purpose of this study was to examine whether commonly used tubes (diameters: 2.1 mm, antimony pH probe and 3.8 mm, nasogastric tube) promote reflux under typical inpatient conditions.
Eight asymptomatic volunteers (five male, mean age 27.6 yr) underwent three sessions, each lasting 6 hours postprandially, while supine with the head elevated 20 degrees. In randomized order, the subjects had either a 2.1-mm tube, 3.8-mm tube, and 2.1-mm tube together or no tube across the EGJ. The subjects were fed 500 ml of Ensure Plus at the beginning of the study. Reflux was measured by a pH probe placed 5 cm above the lower esophageal sphincter. The number of reflux episodes, number of reflux episodes more than 5 minutes, longest reflux episode, time esophageal pH was less than 4, and percentage total time pH was less than 4 were evaluated.
Over the 6 hours, no abnormal reflux was shown with either tube size across the EGJ.
Over a 6-h period, a tube (pH probe alone or combined with nasogastric tube) across the EGJ does not promote an increase in the amount of postprandial supine gastroesophageal reflux in normal volunteers.
既往报道对于横跨食管胃交界（EGJ）放置的导管是否会促进反流以及随后是否存在食管黏膜损伤的可能性得出了相互矛盾的结论。本研究的目的是检验常用导管（直径：2.1毫米，锑制pH探头和3.8毫米，鼻胃管）在典型住院条件下是否会促进反流。
八名无症状志愿者（五名男性，平均年龄27.6岁）进行了三个阶段的试验，每个阶段餐后持续6小时，仰卧位且头部抬高20度。按照随机顺序，受试者分别接受2.1毫米导管、3.8毫米导管、2.1毫米导管联合放置或不放置横跨EGJ的导管。在研究开始时给受试者喂食500毫升安素益儿。通过放置在食管下括约肌上方5厘米处的pH探头测量反流情况。评估反流发作次数、超过5分钟的反流发作次数、最长反流发作时间、食管pH值低于4的时间以及pH值低于4的总时间百分比。
在6小时内，无论横跨EGJ放置哪种尺寸的导管，均未显示出异常反流。
在6小时期间，横跨EGJ放置的导管（单独的pH探头或与鼻胃管联合）不会促使正常志愿者餐后仰卧位胃食管反流量增加。
