Seizure disorder as a risk factor for gastroesophageal reflux in children with neurodevelopmental disabilities
Seizure disorder as a risk factor for gastroesophageal reflux in children with neurodevelopmental disabilities
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DOI：
10.1177/000992280404300608
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发表时间：
2004-07-01
影响因子：
1.6
通讯作者：
Edwards, KS
中科院分区：
文献类型：
--
作者：
Harrington, JW;Brand, DA;Edwards, KS
有严重神经发育障碍的儿童在胃造口术后出现胃食管反流症状的比例尚未得到充分研究。我们回顾了1987年至1997年期间在我们机构接受胃造口术管（同时进行或不进行抗反流手术）的儿童的病历，以确定胃造口术时的神经学相关诊断，诊断性检查以检测反流，以及出院后2年内再次入院的日期和原因。在102例患者中，37例仅接受胃造口术管。这些患者中有30例获得了完整的随访数据，其中7例（23%）在2年内需要进行后续抗反流手术。与其他患者相比，癫痫发作患者再次入院接受该手术的风险大于4倍（57% [4/7] vs. 13% [3/23]; P=0.03）。在患有严重神经发育障碍的儿童中，在胃造口术手术时存在癫痫发作障碍会使随后需要抗反流手术的风险增加4倍。
The proportion of children with severe neurodevelopmental disabilities, in whom symptoms of gastroesophageal reflux develop after gastrostomy placement, has not been well studied. The medical records of children who received a gastrostomy tube (with or without a simultaneous antireflux procedure) at our institution between 1987 and 1997 were reviewed to identify neurologically related diagnoses at the time of the gastrostomy, diagnostic tests ordered to detect reflux, and dates and reasons for re-admissions within 2 years of discharge. Of 102 patients studied, 37 received a gastrostomy tube alone. Complete follow-up data were available for 30 of these patients, 7 of whom (23%) required subsequent antireflux surgery within 2 years. Patients with a seizure disorder had greater than a 4-fold risk of re-admission for this operation compared with other patients (57% [4/7] vs. 13% [3/23]; P=0.03). In a child with severe neurodevelopmental disability, the existence of a seizure disorder at the time of a gastrostomy operation increases the risk of subsequently requiring an antireflux procedure by a factor of 4.