新生儿胃肠镜的难点与展望

Difficulties and prospects of gastrointestinal endoscopy for neonates

目前国内一些儿童医院和少数大型医院开展了新生儿胃肠镜检查,经验丰富的消化内镜医师运用超细胃镜可顺利地完成新生儿胃肠镜检查。早年检查的适应证主要是上消化道出血,而胃镜下发现病变绝大多数是应激性胃十二指肠黏膜损伤,对这部分病人可根据经验先使用质子泵抑制剂,可以使很多病人避免胃镜检查。这一领域的难点主要是设备的改进、适应证的扩展,从而提高对新生儿消化道疾病的诊断和治疗水平。针对先天性消化道畸形的内镜下治疗是该领域未来的发展方向。

At present,some domestic children＇s hospitals and a few large hospitals have carried out neonatal gastrointestinal endoscopy. Experienced gastrointestinal endoscopy physicians can successfully complete the neonatal gastrointestinal endoscopy by ultrathin gastroscope. Early Indications for examination are mainly upper gastrointestinal bleeding,and gastroscopy finds that the majority of lesions are stress-induced duodenal mucosal injury. For these patients,proton pump inhibitors can be used empirically and many patients can avoid gastroscopy. The difficulties in this field are mainly the improvement of equipment and the expansion of indications,so as to improve the level of diagnosis and treatment of neonatal digestive tract diseases. Endoscopic treatment for congenital malformation of digestive tract is the future development direction of this field.