窒息后新生儿胃食管测压及双pH监测的研究

目的探讨出生窒息对新生儿胃肠运动功能的影响。方法用多导生理记录仪测定了３５例窒息后新生儿和１７名对照新生儿的食管和胃内压力，并用晶体锑双ｐＨ微电极和便携式２４小时ｐＨ记录仪，对受试者进行了２４小时胃食管双ｐＨ动态监测。结果两组食管及胃内测压差异不显著；双ｐＨ动态监测发现，窒息组反映酸性胃食管返流的各项参数均明显高于对照组，其中酸性返流指数窒息组／对照组为７．１／１．３；返流次数为１３７．４／２８．５；返流＞５分钟的次数５．９／０．７；ｐＨ＜４总时间１５７．０／２０．１；食管廓清时间１．０／０．４，差异均有非常显著意义（Ｐ＜０．０１）。结论窒息后新生儿酸性胃食管返流较对照组明显增加，各项参数已超过病理性胃食管返流诊断标准

A study on gastroesophageal gastric manometry and 24 hours double pH monitoring in neonates with asphyxia

Objective To investigate the effects of perinatal asphyxia on gastroenteric motility of the newborn. Methods Thirty five asphyxiated full term newborns and 17 controls were enrolled in this study. Their gastric and esophageal pressures were meassured with multichannel physiological recorder. After the manometry, 24 hours double pH monitoring of esophagus and stomach was performed with two antimony pH microelectrodes and appropriated pocket pH meter. Results No significant difference in gastric and esophageal pressures between patients and controls was found. The 24 hours pH monitoring revealed that the variables of acid reflux in asphyxia group were all dramatically higher than those of controls. The acid reflux index was 7.1/1.3 (asphyxia group/control group), the number of reflux episodes was 137.4/28.5, the number of reflux over 5 min was 5.9/0.7, the total time of pH<4 were 157.0/20.1. The differences were all siginificant ( P <0.001). Conclusion Neonates with birth asphyxia may suffer from more attacks of gastroesophageal acid reflux than the normal controls.