儿童胃食管反流病危险因素的相关性分析

Correlation analysis of risk factors of gastroesophageal reflux disease in children

目的探讨儿童胃食管反流病(GERD)的相关危险因素。方法选取自2015年1月至2019年1月于新疆维吾尔自治区人民医院小儿外科接受手术或准备手术患儿76例和70例无GERD患儿作为研究对象。其中GERD患儿作为实验组,无GERD患儿作为对照组。统计2组患儿年龄、性别等一般资料,临床表现、实验室检查指标、手术情况。结果2组患者年龄、性别等一般因素之间无统计学差异(P>0.05)。3~7岁儿童中GERD病的发生率较高,但2组患者间差异无统计学意义。2组3~7年龄段儿童中咳嗽有差异,实验组患儿反流症状明显,小于3岁患儿饭后呕吐明显,发烧患儿多伴有反流症状。2组患儿的白细胞计数与反流症状差异无统计学意义;实验组患儿身体质量指数(BMI)指数大于28者的反流症状显著高于对照组,且早产儿中患者GERD的发生率较对照组高;手术后患儿的反流症状较非手术患儿的高,平卧位时反流出现概率高于站立位(见表1)。对咳嗽、反流、发烧、身体质量指数、早产、接受手术及体位进行二元分类后行Logistic回归分析,BMI指数分为>28和≤28。结果显示,影响GERD的危险因素是反流、呕吐、BMI指数>28(OR=12.149,8.679,0.027;P<0.05)。概率结论体重指数高、反流、呕吐等因素均可能为GERD患儿的危险因素,正确认识及早期发现危险因素可提高GERD的诊断及治疗。

Objective To analyze the risk factors related to gastroesophageal reflux disease(GERD)in hospitalized children with pediatric surgery.From January 2015 to January 2019,children from the Department of Pediatric Surgery,People's Hospital of Xinjiang Uygur Autonomous Region.Among them,76 children with gastroesophageal reflux disease were screened by medical imaging and Gerd-Q rating scale,and 70 children with GERD were not found.Results There was no significant difference in the general factors such as age and gender between the two groups(P>0.05).The incidence of gastroesophageal reflux disease was better in children aged 3~7 years from the age distribution,but there was no statistics between the two groups.Learning differences,cough was significantly different in 3~7 children,reflux was the most obvious symptom in the GERD group,vomiting after meals was more pronounced in the group less than 3 years old,and reflux symptoms were obvious in the children with fever,but the two groups There was no significant difference in the increase of white blood cell count and reflux in children(P<0.05).The reflux symptoms in children with Body mass index(BMI)index greater than 28 were significantly higher than those in the control group.Gastroesophageal reflux in premature infants was found in this study.The incidence of the disease was higher than that of the control group(P<0.05).The reflux symptoms of the children after surgery were higher than those of the non-surgical children.The incidence of reflux in the supine position was higher than that of the standing position(P<0.05).Logistic regression analysis showed that reflux(OR=12.149),vomiting(OR=8.679)and BMI of>28(OR=0.027)were independent risk factors for GERD.Conclusion High body mass index,reflux and vomiting may be the risk factors for children with gastroesophageal reflux disease.Correct recognition and early detection of risk factors can improve the diagnosis and treatment of gastroesophageal reflux disease.