肥厚性幽门狭窄手术前后胃食管pH动态改变

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目的 采用 2 4hpH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 2 8例肥厚性幽门狭窄患儿及 2 1例正常儿行胃食管 2 4hpH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 5 7.1%。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 ,6 4 .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 Objective To observe the changes of gastric esophageal pH before and after operation in children with hypertrophic pyloric stenosis by 24 hpH dynamic monitoring technique. Methods 28 cases of hypertrophic pyloric stenosis and 21 normal children underwent gastrointestinal 24 hpH dynamic monitoring. Results The preoperative acidogastric-gastroesophageal reflux index in children group was significantly higher than that in control group, accounting for 51.1%. At 3 and 7 days postoperatively, the indexes of acid reflux were significantly decreased and the indexes of duodenal reflux were increased. Duodenogastric reflux and mixed gastroesophageal reflux were found in 64.2% postoperatively, and postoperative 1 Month re-examination of gastroesophageal reflux index was significantly reduced. Conclusions Hypertrophic pyloric stenosis is predominantly acidic and gastroesophageal reflux before surgery, and duodenogastric reflux and mixed reflux are the main symptoms. With postoperative recovery of pyloric tissue structure and function, reflux can be gradually improved
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