中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
7期
498-500
,共3页
刘志峰%郝理华%金玉%王珏%孔桂萍
劉誌峰%郝理華%金玉%王玨%孔桂萍
류지봉%학리화%금옥%왕각%공계평
吞气症%功能性胃肠病%多通道腔内阻抗技术%儿童
吞氣癥%功能性胃腸病%多通道腔內阻抗技術%兒童
탄기증%공능성위장병%다통도강내조항기술%인동
Aerophagia%Functional gastrointestinal disorder%Multichannel intraluminal impedance%Child
目的 探讨儿童吞气症的临床特点及24 h食管阻抗监测在儿童吞气症诊断中的作用.方法 选取2005年7月至2013年6月南京医科大学附属南京儿童医院消化科门诊接诊和住院部吞气症患儿30例,其中8例行24 h食管阻抗监测,分析其临床特点.患儿治疗主要包括心理疏导、饮食调节及口服乳果糖、多潘立酮口服液和多种维生素.经过上述处理仍然无效的患儿给于口服西甲硅油治疗.结果 30例患儿年龄2～13(8.6±4.5)岁,临床主诉为腹胀[30例(100.00％)],可以看见的或不自主的吞气现象28例(93.33％),频繁嗳气27例(90.00％),食欲不振25例(83.33％),便秘22例(73.33％),心理上有不同程度的压力15例(50.00％),反复腹痛10例(33.33％),慢性腹泻3例(10.00％),急性腹痛3例(10.00％).8例行24 h食管阻抗监测,24 h气体吞咽最多553次,最少1例47次,平均149.63次.经过心理疏导、饮食调节、口服药物治疗,其中24例(80.00％)得到缓解;6例(20.00％)严重者口服西甲硅油治疗后症状得到缓解.结论 儿童吞气症多表现为腹胀、不自主的吞气现象、频繁嗳气、食欲不振、便秘及反复腹痛.经心理疏导、饮食调节,适当的通便药、胃肠动力药和多种维生素治疗多可治愈.24 h食管阻抗监测检查可监测气体吞咽及气体反流,对儿童吞气症诊断有所帮助.
目的 探討兒童吞氣癥的臨床特點及24 h食管阻抗鑑測在兒童吞氣癥診斷中的作用.方法 選取2005年7月至2013年6月南京醫科大學附屬南京兒童醫院消化科門診接診和住院部吞氣癥患兒30例,其中8例行24 h食管阻抗鑑測,分析其臨床特點.患兒治療主要包括心理疏導、飲食調節及口服乳果糖、多潘立酮口服液和多種維生素.經過上述處理仍然無效的患兒給于口服西甲硅油治療.結果 30例患兒年齡2～13(8.6±4.5)歲,臨床主訴為腹脹[30例(100.00％)],可以看見的或不自主的吞氣現象28例(93.33％),頻繁噯氣27例(90.00％),食欲不振25例(83.33％),便祕22例(73.33％),心理上有不同程度的壓力15例(50.00％),反複腹痛10例(33.33％),慢性腹瀉3例(10.00％),急性腹痛3例(10.00％).8例行24 h食管阻抗鑑測,24 h氣體吞嚥最多553次,最少1例47次,平均149.63次.經過心理疏導、飲食調節、口服藥物治療,其中24例(80.00％)得到緩解;6例(20.00％)嚴重者口服西甲硅油治療後癥狀得到緩解.結論 兒童吞氣癥多錶現為腹脹、不自主的吞氣現象、頻繁噯氣、食欲不振、便祕及反複腹痛.經心理疏導、飲食調節,適噹的通便藥、胃腸動力藥和多種維生素治療多可治愈.24 h食管阻抗鑑測檢查可鑑測氣體吞嚥及氣體反流,對兒童吞氣癥診斷有所幫助.
목적 탐토인동탄기증적림상특점급24 h식관조항감측재인동탄기증진단중적작용.방법 선취2005년7월지2013년6월남경의과대학부속남경인동의원소화과문진접진화주원부탄기증환인30례,기중8례행24 h식관조항감측,분석기림상특점.환인치료주요포괄심리소도、음식조절급구복유과당、다반립동구복액화다충유생소.경과상술처리잉연무효적환인급우구복서갑규유치료.결과 30례환인년령2～13(8.6±4.5)세,림상주소위복창[30례(100.00％)],가이간견적혹불자주적탄기현상28례(93.33％),빈번애기27례(90.00％),식욕불진25례(83.33％),편비22례(73.33％),심리상유불동정도적압력15례(50.00％),반복복통10례(33.33％),만성복사3례(10.00％),급성복통3례(10.00％).8례행24 h식관조항감측,24 h기체탄인최다553차,최소1례47차,평균149.63차.경과심리소도、음식조절、구복약물치료,기중24례(80.00％)득도완해;6례(20.00％)엄중자구복서갑규유치료후증상득도완해.결론 인동탄기증다표현위복창、불자주적탄기현상、빈번애기、식욕불진、편비급반복복통.경심리소도、음식조절,괄당적통편약、위장동력약화다충유생소치료다가치유.24 h식관조항감측검사가감측기체탄인급기체반류,대인동탄기증진단유소방조.
Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.
