[在儿童中使用质子抑制剂的区域差异]
Emilie Raaum Closs1, Miriam Lyamouri1, Knut Øymar2
1Medisinsk fakultet, Universitetet i Oslo.
概括
在婴儿中使用质子抑制剂显著增加,尽管指南建议限制使用. 这一趋势,加上区域差异,表明婴儿反流的潜在过度治疗,许多病例缺乏诊断支持.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 临床药理学 临床药理学
- 公共卫生 公共卫生
背景情况:
- 区分生理性胃食道逆流与婴儿的逆流疾病是具有挑战性的.
- 国际指导方针提倡小心对婴儿进行酸性抑制治疗,因为有效性的证据有限.
- 近年来,对婴儿和老年儿童的酸抑制疗法的处方增加了.
研究的目的:
- 分析儿童疑似胃食道逆流病的调查和治疗趋势.
- 为了检查小儿胃食道逆流病的管理中的地理差异.
- 评估对婴儿酸性抑制治疗指南的遵守情况.
主要方法:
- 利用挪威处方药登记处 (2007-2020年) 的综合数据来追踪儿童和青少年的质子抑制剂 (PPI) 处方.
- 从挪威患者登记处分析数据,以确定24小时pH监测和胃镜的使用情况.
- 检查了PPI处方和诊断程序的区域差异.
主要成果:
- 在挪威东南部,2007年至2020年,在出生第一年内分发质子抑制剂的数量大幅增加,从每1000名儿童中的10.1名增加到每1000名儿童中的54.7名.
- 观察到显著的区域差异,挪威东南部在2020年与挪威北部和中部相比,分发率高出64%.
- 虽然胃镜率保持稳定,但24小时pH测量的使用从2016年到2020年减少了52%.
结论:
- 与既定指导方针相反,婴儿中PPI使用的大幅增加,以及区域差异,表明生理反流的潜在过度治疗.
- 越来越多的儿科患者似乎在没有足够的诊断确认的情况下接受逆流治疗.
- 需要进一步的研究,以了解这些趋势的驱动因素,并确保适当管理儿童的胃食道逆流病.
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