ESOPHAGEAL BODY AND LOWER ESOPHAGEAL SPHINCTER FUNCTION IN HEALTHY PREMATURE-INFANTS
ESOPHAGEAL BODY AND LOWER ESOPHAGEAL SPHINCTER FUNCTION IN HEALTHY PREMATURE-INFANTS
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DOI：
10.1016/0016-5085(95)90741-6
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发表时间：
1995-12-01
期刊：
影响因子：
29.4
通讯作者：
DENT, J
中科院分区：
文献类型：
--
作者：
OMARI, TI;MIKI, K;DENT, J
背景与目的：胃食管反流是早产儿的常见病。本研究的目的是使用一种新的压力测量技术来测量早产儿食管体和食管下括约肌压力。方法：采用包含4-9个测压通道的微测压喂养装置（外径小于或等于2mm），对27例早产儿进行49项研究。进食后20分钟，记录三个部位食管体动力。通过面部刺激（Santmyer反射）刺激吞咽20次（每分钟1次）。在32项研究中，进食前后15分钟记录食管下括约肌压力（套筒）。结果：蠕动运动模式比非蠕动运动模式更少见（26.6% vs. 73.4%; P < 0.0001），包括31.1%的同步压力波，34.6%的不完全压力波和6.3%的逆行压力波。孕龄大于34周的新生儿反射性吞咽的发生率高于小于34周的婴儿（33.4% vs. 20.4%; P < 0.05）。进食前平均食管下括约肌压20.5 +/- 1.7 mm Hg，进食后平均13.7 +/- 1.3 mm Hg （P < 0.0005）。结论：早产儿表现出非蠕动性食管运动，这可能导致反流物质清除不良。相比之下，下食道括约肌的机制似乎很发达。
Background & Aims: Gastroesophageal reflux is a common problem in premature infants. The aim of this study was to use a novel manometric technique to measure esophageal body and lower esophageal sphincter pressures in premature infants. Methods: Micromanometric feeding assemblies (OD, less than or equal to 2 mm) incorporating 4-9 manometric channels were used in 49 studies of 27 premature neonates. Esophageal body motility was recorded at three sites for 20 minutes after feeding. Twenty attempts (one per minute) were made to stimulate swallowing via facial stimulation (Santmyer reflex). In 32 studies, lower esophageal sphincter pressures were recorded (sleeve) for 15 minutes before and after feeding. Results: Peristaltic motor patterns were less common than nonperistaltic motor patterns (26.6% vs. 73.4%; P < 0.0001) that comprised 31.1% synchronous, 34.6% incomplete, and 6.3% retrograde pressure waves. Reflex swallowing was elicited more frequently in neonates older than 34 weeks postconceptional age than in younger infants (33.4% vs. 20.4%; P < 0.05). Mean lower esophageal sphincter pressure was 20.5 +/- 1.7 mm Hg before and 13.7 +/- 1.3 mm Hg after feeding (P < 0.0005). Conclusions: Premature infants show nonperistaltic esophageal motility that may contribute to poor clearance of refluxed material. In contrast, the lower esophageal sphincter mechanisms seem well developed.