先天性膈疝术后食管功能及胃食管反流的临床观察

目的 了解先天性膈疝修补术后预后及术后食管功能和胃食管反流情况。方法 对46例先天性膈疝修补术后进行随访，13例进行了24h食管双极pH及24h动态压力测定，了解胃食管功能。结果 13例进行了24h食管pH及压力测定的膈疝修补术后患儿中，7例有胃食管反流，其中3例术中应用补片，4例术前显示胃疝入胸腔。结论 先天性膈疝修补术后可出现胃食管反流，24h测压及pH测定表现为食管蠕动功能明显减弱，这种食管下端蠕动功能减弱与膈疝修补术后出现胃食管连接解剖异常及膈肌发育不良可能相关。

Esophageal motility and gastroesophageal reflux after congenital diaphragmatic hernia repair

Objective To study the esophageal motility and gastroesophageal reflux of congenital diaphragmatic hernia(CDH) after operation.Methods Thirteen out of 46 cases with CDH were reviewed postoperatively for gastroesophageal reflux (GER) using the 24 hour pH probe measurement and lower esophageal sphincter manometrics.Results The examination revealed pathological GER in 7 patients.In which 3 cases were used diaphragmatic patches during hernia repair,4 were preoperative stomach herniation into the thoracic cavity.Conclusion Dysfunction of the lower esophageal sphincter,disordered esophageal motility,altered anatomy of esophagogastric junction all play a role in the postoperative GER of congenital diaphragmatic hernia.