胃食管反流病表现呼吸道症状患儿围手术期的诊疗经验分享

Experience in perioperative diagnosis and treatment of children with respiratory symptoms of gastroesophageal reflux disease

目的评价成人胃食管反流病筛查表在5岁以上儿童的筛选及抑酸治疗的临床价值。方法选择2012年3月至2019年6月在新疆维吾尔自治区人民医院小儿外科围手术期患儿作为研究对象,填写胃食管反流病问卷(GERD-Q)评分量表筛选出的胃食管反流病患儿109例作为研究对象,非反流患儿60例作为对照组。观察2组患儿一般临床症状及检验指标间的相关性及疗效。结果既往误诊为支气管炎治疗组的患儿43例,具有静脉奥美拉唑抑酸治疗后第2天开始咳嗽咳痰等症状明显好转,症状完全控制所需时间为(4.0±1.2)d,以肺炎为诊断的39例患儿中抗炎+抑酸治疗后症状控制所需时间为(5.0±1.6)d,以哮喘为误诊的27例患儿中用抑酸治疗后症状完全缓解时间为(6.0±2.1)d。试验组中GERD-Q评分量表平均值(11.7±2.6)分,而对照组平均为(6.4±1.8)分,差异有统计学意义(P<0.05)。试验组患儿在治疗后再次进行GERD-Q评分平均分(6.1±1.2)分,与治疗前的评分差异有统计学意义(P<0.05),而与对照组GERD-Q评分差异无统计学意义(P>0.05)。结论GERD-Q在5岁以上患儿中具有筛选胃食管反流病的作用,早期诊断及时抑酸治疗可以控制胃食管反流病引起的气道症,改善患儿生活质量,可能缩短住院时间。

Objective To evaluate the clinical value of adult gastroesophageal reflux disease screening in children over 5 years old and in the treatment of acid suppression.Method From March 2012 to June 2019,in the Department of Pediatric Surgery,People's Hospital of Xinjiang Uygur Autonomous Region Children in the operation period were enrolled in the study.109 children with gastroesophageal reflux disease were selected by the gastroesophageal reflux disease questionnaire(GERD-Q)scale.60 children with non-reflux were used as the control group.The correlation and efficacy between the general clinical symptoms and test indicators of the two groups were observed.Results 43 cases of children who were misdiagnosed as bronchitis treatment group,the symptoms of cough and cough were obviously improved on the second day after intravenous omeprazole inhibition treatment.The time required for complete control of symptoms was 4.0±1.2 days.For the 39 children diagnosed,the time required for symptom control after antiinflammatory±acid suppression treatment was(5.0±1.6)days.In 27 case with misdiagnosis of asthma,the symptoms of cough and cough were obviously improved on the second day after intravenous omeprazole inhibition treatment.The time required for complete control of symptoms was(6.0±2.1)days.The average value of the GERD-Q rating scale in the experimental group was(11.7±2.6)points,while the average in the control group was[(6.4±1.8)points;P<0.05].The mean score of the GERD-Q score of the children in the experimental group was(6.1±1.2)points after treatment,which was statistically significant(P<0.05),but not statistically significant(P>0.05).Conclusion GERD-Q has the effect of screening for gastroesophageal reflux disease in children over 5 years old.Early diagnosis and timely acid suppression treatment can control airway disease caused by gastroesophageal reflux disease,improve life treatment of children,and shorten hospitalization time.