Percutaneous endoscopic gastrostomy and gastrooesophageal reflux in neurologically impaired children

作     者：Mike Thomson Prithviraj Rao David Rawat Tobias G Wenzl 

作者机构：Centre for Paediatric GastroenterologyRoyal Free and University College Medical School Centre for Paediatric GastroenterologySheffield Childrens NHS TrustWestern BankSheffieldS10 2TH United Kingdom KinderklinikUniversittsklinikum Aachen 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第2期

页      面：191-196页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：儿童 回流 内镜 神经学 胃 PEG 神经功能 pH值 

摘      要：AIM:To investigate the effects of percutaneous endoscopic gastrostomy(PEG) feeding on gastro-oesophageal reflux(GOR) in a group of these children using combined intraluminal pH and multiple intraluminal impedance(pH/MII) . METHODS:Ten neurologically impaired children underwent 12 h combined pH/MII procedures at least 1 d before and at least 12 d after PEG placement. METHODS:Prior to PEG placement(pre-PEG) a total of 183 GOR episodes were detected,156(85.2%) were non-acidic.After PEG placement(post-PEG) a total of 355 episodes were detected,182(51.3%) were nonacidic.The total number of distal acid reflux events statistically significantly increased post-PEG placement(prePEG total 27,post-PEG total 173,P=0.028) and themean distal pH decreased by 1.1 units.The distal reflux index therefore also significantly increased post-PEG [pre-PEG 0.25(0-2) ,post-PEG 2.95(0-40) ].Average proximal pH was lower post-PEG but the within subject difference was not statistically significant(P=0.058) . Median number of non-acid GOR,average reflux height,total acid clearance time and total bolus clearance time were all lower pre-PEG,but not statistically significant. CONCLUSION:PEG placement increases GOR episodes in neurologically impaired children.