【摘要】 探讨早产儿胃食道反流（ＧＥＲ）的早期实用诊断和预防方法。方法：利用２４小时ｐＨ值自动记录仪测定４０例早产儿的食道下端ｐＨ值，当ｐＨ＜４、持续时间＞１５秒为１次反流，同时应用Ｂ超检测胃排空率，观察与ｐＨ计的相关性。结果：４０例早产儿中ＧＥＲ阳性率为８２．５％（３３／４０），其中８０％为无症状型。当患儿头抬高３０度时或日龄≥１５天者，ＧＥＲ发生率逐步下降且ｐＨ及各项参数降低。ＧＥＲ的参数与喂奶后６０分的胃排空率呈负相关，当胃排空率＜４５％或＜５０％时ＧＥ Ｒ阳性率为９４．７％和８２％。结论：食道下端ｐＨ连续测定仪可早期诊断早产儿ＧＥＲ。喂奶后１小时Ｂ超测定胃排空率简便无损伤，可作为早产儿ＧＥＲ的早期筛查方法。婴儿仰卧头抬高３０度可减少ＧＥＲ发生。更多还原

【Abstract】 To investigate the early and practical diagnosis and management of gastroesophageal reflux(GER)in preterm infants. Methods: 24-hours pH monitoring was performed in forty preterm infants, meanwhile gastric emptying rate was per- formed by ultrasonography to search the relationship between gastric emptying rate and GER. Results: The positive rate of GER in preterm infants was 82. 5 % in which 80% without clinical symptoms. While baby’s head was padded on 30?high or the age was more than 15 days, the incidence of GER would be declined. After feeding 60 min the parameter of GER had negative correlation with gastric emptying rate. The positive rates of GER were 94.7% and 82% while gastric emptying rates were less than 45% and 50% respectively. Conclusion:Early and reliable diagnosis of GER in preterm infants can be performed by distal esophageal 24 hours pH monitoring and using ultrasonography for monitoring gastric emptying rate. This method,was simple and noninvasive, it can be used for early screening of doubtful GER in preterm infants. Furthermore, if padding baby’s head on 30?high,it could decrease the occurrence of GER.更多还原