健康儿童及病理性胃食管反流患儿食管动力功能研究

目的了解小儿食管运动的生理学，探讨小儿病理性胃食管反流(GER)发生的食管动力学基础。方法对60例健康儿童和62例经食管pH监测诊断为病理性GER的患儿用低顺应性毛细管灌注系统进行食管测压研究，并对健康儿童组不同年龄段之间，两组同一年龄段之间进行食管动力功能比较。结果健康儿童组下食管括约肌长度(LESL)随着年龄的增加而增长，胸内段和腹内段也相应增加(P＜0.01)，下食管括约肌压力(LESP)以～1岁组为高(P＜0.05)；上食管括约肌长度(UESL)随年龄的增加而增长(P＜0.01)，上食管括约肌压力(UESP)以～1岁组和～3岁组为低(P＜0.01)。病理性反流患儿的食管动力功能，除～7岁组食管蠕动传导速度低于同一年龄段健康儿童外(P＜0.05)，其余指标两组同一年龄段间的差异均无显著性。结论LESP的抗反流功能与年龄关系不大，LESL、UESL和UESP的功能3岁以后逐渐成熟，小儿病理性GER的发生与LESP、LESL关系不大。

Esophageal motility in healthy children and children with pathological gastroesoplhageal reflux

Objective To learn the physiology of esophageal motility and to examine the esophageal motility basis in the occurrence of gastroesophageal reflux (GER) in children.Methods Esophageal manometry was measured by low compliance capillary infusion system (PC Polygraf HR) in 60 healthy children and 62 patients with pathological GER diagnosed by 24-hr esophageal pH detection.The esophageal motility function was investigated among different age groups in healthy children and between the patients and the healthy at the same ages.Results Lower esophageal sphincter length (LESL),the intro-abdominal length and intro-thoracal length of LES increased with age in healthy children(P<0.01).Lower esophageal sphincter pressure(LESP)was higher in 1-year group compared to the other age groups(P<0.05).Upper esophageal sphincter length(UESL)increased with the age.Upper esophageal sphincter pressures(UESP)were lower in 1 and 3-year groups than that in other age groups(P<0.01).Except for the lower velocity of peristalsis in 7-year group,there were no significant differences in esophageal motility between the GER patients and the age matched control groups.Conclusion\ There is no correlation between the antireflux ability of LESP and the age in children.The LEST,UESL and UESP function will mature gradually after 3 years old.It suggests that the LESP and LESL are not the major factors that determine the occurrence of pathological GER in children.