De Vita C, Berni Canani F, Cirillo B, Della Rotonda G M, Berni Canani R
Divisione O.R.L., Azienda Ospedaliera Santobono.
Acta Otorhinolaryngol Ital. 1996 Oct;16(5):407-11.
In children, gastroesophageal reflux (GER) plays an important role in both acute and chronic upper airway disorders including stridor, chronic cough, recurrent upper respiratory infections, obstructive apnea, laryngospasm, and wheezing. Diagnosis may prove difficult unless there is reason to suspect GER and one is aware of the concept of "silent" GER. This paper presents our experience with chronic and/or recurrent respiratory disorders of uncertain origin and without gastrointestinal symptoms in children. Thirty-two pediatric patients with upper respiratory symptoms were evaluated. Out-patient 24-hour intraesophageal pH was monitored and 56% of the patients underwent pharyngo-laryngeal fibroscopy. The patients were divided into two subgroups: Group A (18 patients < 6 months of age) and Group B (14 patients > 6 months). All the patients tested positive for GER with a mean Reflux Index of 21.5. The most common symptoms in Group A were apnea-cianosis and stridor while they were chronic cough for group B. The present study confirms the association between GER and respiratory disease and between GER respiratory-related symptoms and patient age. Emphasis is placed on the importance of otolaryngological diagnostic procedures and 24-hour pH-gastroesophageal monitoring in evaluating patients with respiratory disorders related to silent GER.
在儿童中，胃食管反流（GER）在急慢性上气道疾病中都起着重要作用，这些疾病包括喘鸣、慢性咳嗽、反复上呼吸道感染、阻塞性呼吸暂停、喉痉挛和喘息。除非有理由怀疑GER且了解“隐性”GER的概念，否则诊断可能会很困难。本文介绍了我们对儿童中病因不明且无胃肠道症状的慢性和/或反复呼吸道疾病的经验。对32例有上呼吸道症状的儿科患者进行了评估。对门诊患者进行了24小时食管内pH监测，56%的患者接受了咽喉纤维镜检查。患者被分为两个亚组：A组（18例年龄小于6个月）和B组（14例年龄大于6个月）。所有患者GER检测均呈阳性，平均反流指数为21.5。A组最常见的症状是呼吸暂停-发绀和喘鸣，而B组是慢性咳嗽。本研究证实了GER与呼吸系统疾病之间以及GER相关呼吸道症状与患者年龄之间的关联。强调了耳鼻喉科诊断程序和24小时pH值-胃食管监测在评估与隐性GER相关的呼吸系统疾病患者中的重要性。
