危重症患者胃食管反流相关问题的研究进展

Gastroesophageal reflux and reflux-related complications in critically ill patients

危重症患者由于存在气管插管/机械通气、鼻饲/肠内营养等诊疗操作加之存在程度不等的意识障碍,长期卧床,腹内压升高等高危因素,使胃食管反流十分常见,其危害性不但引起胃食管反流病,更重要的引起吸入性肺炎、急性肺损伤、源性呼吸窘迫等呼吸系危象,还可导致非心源性胸痛,新生儿猝死.其诸多不良反应并同原发病一起影响患者预后,提高对胃食管反流病的诊断水平,并采取相应的防治措施十分必要.

There are numerous risk factors for gastroesophageal reflux（GER）in critically ill patients,such as tracheal intubation/mechanical ventilation,tube feeding,decreased level of consciousness,sustained supine position,and high intra-abdominal pressure.Therefore,GER is very common in critically ill patients.Patients who suffered from GER are liable not only to gastroesophageal reflux disease（GERD）but also to other severe complications such as aspiration pneumonia,acute lung injury,GERD-derived respiratory distress,noncardiac chest pain（NCCP）,and sudden infant death（SID）.As GER and its complications can greatly affect patients＇prognosis,improving the diagnosis of GER and taking precaution measures are of great importance to critically ill patients.