Gastric emptying and gastro-oesophageal reflux in preterm infants
Gastric emptying and gastro-oesophageal reflux in preterm infants
复制标题
DOI：
10.1136/fn.75.2.f117
复制
发表时间：
1996-09-01
影响因子：
4.4
通讯作者：
Booth, IW
中科院分区：
文献类型：
--
作者：
Ewer, AK;Durbin, GM;Booth, IW
胃食管反流在早产儿中很常见，但胃排空作为一个致病因素的作用以前还没有研究过。因此，在19例健康早产儿（中位胎龄32周）中测量胃排空，同时使用锑pH电极测压定位测量24小时食管下段pH。获得胃窦的真实的时间超声图像，并在鼻饲前即刻测量胃窦横截面积（阿克萨），然后在随后的胃排空期间测量，直到阿克萨恢复到其进食前的值。半排空时间（50% Δ阿克萨）计算为阿克萨下降至餐后最大增量一半所需的时间，该组的平均（SEM）反流指数为11.9（2.0）%，每24小时反流发作次数：15.4（1.7），反流发作时间超过5分钟的次数为5.5（0.8）。单个婴儿的平均半排空时间为：中位数（范围）46（18-105）分钟。胃排空率和胃食管反流的任何指标之间没有关联，无论是在整个24小时内，其中较低的食管pH值被记录，或在餐后期间的饲料后进行超声研究。胃食管反流也与喂养量和喂养类型无关。无症状的胃食管反流在早产儿中很常见，但胃排空时间不是决定因素。食管下括约肌松弛不当或食管动力异常提供了更合理的解释。
Gastro-oesophageal reflux is common in preterm infants, but the role of gastric emptying as a causal factor has not been studied before. Gastric emptying was therefore measured in 19 healthy preterm infants (median gestational age 32 weeks) while concurrently measuring 24 hour lower oesophageal pH, using an antimony pH electrode, positioned manometrically. Real time ultrasonic images of the gastric antrum were obtained, and measurements of antral cross-sectional area (ACSA) were made immediately before a nasogastric feed and then during subsequent gastric emptying until ACSA returned to its pre-feed value. Half emptying time (50% Delta ACSA) was calculated as the time taken for the ACSA to fall to half the maximal postprandial increment.Mean (SEM) reflux index for the group was 11.9 (2.0)%; number of reflux episodes per 24 hours: 15.4 (1.7); and number of reflux episodes longer than five minutes 5.5 (0.8). Average half emptying times for an individual infant were: median (range) 46 (18-105) minutes. There was no association between gastric emptying rates and any of the indices of gastro-oesophageal reflux, either during the entire 24 hour period for which the lower oesophageal pH was recorded, or in the postprandial periods after the feeds which were studied ultrasonically. Gastro-oesophageal reflux was also unrelated to feed volume and feed type.Asymptomatic gastro-oesophageal reflux is common in preterm infants, but gastric emptying time is not a determinant of it. Inappropriate relaxation of the lower oesophageal sphincter or abnormal oesophageal motility offer more plausible explanations.