肥厚性幽门狭窄手术前后胃食管pH动态改变

目的：采用24h pH动态监测技术观察肥厚性幽门狭窄患儿手术前后胃食管pH变化规律。方法：对28例肥厚性幽门狭窄患儿及21例正常儿行胃食管24h pH动态监测。结果：患儿组术前酸性胃食管反流指标较对照组明显增高，占57．1％，术后3，7d复检时，酸性反流指标明显降低，十二指肠胃反流指标增高，64．2％，术后显示十二指肠胃反流和混合性胃食管反流，术后1个月复检时胃食管反流指标明显降低。结论：肥厚性幽门狭窄术前以酸性胃食管反流为主，术后则以十二指肠胃反流和混合性反流为主，随着术后幽门管组织结构和功能的恢复，反流可逐渐改善。

Pre-and post-operative dynamic changes of gastroesophageal pH of hypertrophic pyloric stenosis in children.

Objective To study the gastroesophageal pH changes in patients with hypertrophic pyloric stenosis by 24 hour pH monitoring before and after operation.Methods 28 patients with hypertrophic pyloric stenosis and 21 normal children were subject to 24 hour gastroesophageal pH monitoring.Results The acid reflux was observed on the pre operative group compared to that of the normal. 57.1% patients showed gastroesophageal reflux. Three to seven days post operatively, gastroesophageal acid reflux decreased dramatically while duodenogastric reflux increased. 64.2% patients presented with duodenogastric reflux or mixed gastroesophageal reflux after the operation. The gastroesophageal reflux decreased significantly one month postoperatively.Conclusions Children with hypertrophic pyloric stenosis mainly present with acid gastroesophageal reflux before operation, and present with duodenogastric reflux and mixed reflux after operation. With the improving in the function of the pyloric canal, refluxes should be alleviated.