儿童胃食管反流病诊疗进展
Advances in the Diagnosis and Management of Pediatric Gastroesophageal Reflux Disease
DOI: 10.12677/acm.2025.15123386, PDF,   
作者: 陈 锐*, 王玉婷#:重庆医科大学附属儿童医院消化科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿童神经发育与认知障碍重庆市重点实验室,重庆
关键词: 儿童胃食管反流病诊断与治疗综述Pediatric Gastroesophageal Reflux Disease Diagnosis and Treatment Review
摘要: 胃食管反流病(Gastroesophageal Reflux Disease, GERD)是儿科领域的常见消化系统疾病,其临床表现隐匿且非典型,易与呼吸、营养问题相混淆,导致诊断延迟。近年来,其诊疗观念不断更新,在诊断方面,传统方法正被更精准的技术所补充,多通道腔内阻抗-pH监测能有效区分酸反流、弱酸反流及气体反流,显著提高了诊断的精确性。在治疗方面,更加强调阶梯化管理,生活方式干预是基础。药物治疗中,质子泵抑制剂仍是主流,但对其在婴幼儿中的长期应用安全性关注度日益增加。对于难治性严重GERD,腹腔镜胃底折叠术等抗反流手术是终极手段。本文就儿童GERD的诊断及治疗方面进行综述。
Abstract: Gastroesophageal Reflux Disease (GERD) is a common digestive system disorder in the pediatric field. Its clinical manifestations are often occult and atypical, easily confused with respiratory or nutritional issues, leading to delayed diagnosis. Recently, there have been continuous updates in its diagnostic and therapeutic concepts. In terms of diagnosis, traditional methods are being supplemented by more precise techniques. Multichannel intraluminal impedance-pH monitoring can effectively differentiate between acid reflux, weakly acid reflux, and gas reflux, significantly improving diagnostic accuracy. In treatment, there is a stronger emphasis on stepwise management, with lifestyle interventions serving as the foundation. Among pharmacological treatments, proton pump inhibitors remain the mainstay, though there is increasing concern regarding the long-term safety of their use in infants and young children. For refractory and severe GERD, anti-reflux surgeries such as laparoscopic fundoplication represent the ultimate intervention. This article provides a review of the diagnosis and treatment of GERD in children.
文章引用:陈锐, 王玉婷. 儿童胃食管反流病诊疗进展[J]. 临床医学进展, 2025, 15(12): 105-116. https://doi.org/10.12677/acm.2025.15123386

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