食道缩修复后的酸性抑制:一些婴儿确实受益
Suhail Zeineddin1,2, Gwyneth A Sullivan1,2,3, J Benjamin Pitt1,2
1Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Journal of pediatric gastroenterology and nutrition
|August 5, 2025
概括
酸抑制疗法可能会降低患有复杂食道/气管内食道 (EA/TEF) 修复的婴儿的狭窄率. 对于简单的EA/TEF病例,酸抑制在预防静脉狭窄方面没有显著的益处.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 新生儿护理 新生儿护理
背景情况:
- 酸性抑制通常用于食道/气管管管道 (EA/TEF) 后的修复,以防止静脉狭窄.
- 最近的证据质疑了这种情况下抑制酸的有效性.
- 这项研究调查了大量婴儿队列中酸性抑制和收缩率之间的关联.
研究的目的:
- 为了比较经过EA/TEF修复的婴儿在酸抑制和没有酸抑制的情况下出现的静脉狭窄率.
- 为了确定酸性抑制是否有利于预防简单与复杂的EA/TEF病例中的狭窄.
主要方法:
- 在使用儿科健康信息系统分析了接受EA/TEF修复 (2010-2022) 的婴儿的全国性样本.
- 酸性抑制是由H2阻断剂或PPI使用定义的.
- 复杂的EA/TEF修复包括延迟修复,G管安置,长时间住院或多次光镜等标准. 缩扩张是主要结果.
主要成果:
- 在1445名婴儿中,17.8%需要1年扩张.
- 对于简单的EA/TEF,随着或没有酸抑制,收缩率相似 (17.5%与17.0%,p=0.90).
- 在复杂的EA/TEF病例中,接受酸性抑制的患者的收缩率显著降低 (15.3%与26.0%,p=0.001).
结论:
- 手术后的酸性抑制与复杂的EA/TEF修复中狭窄发生率的减少有关.
- 减少酸抑制可能适用于简单的EA/TEF修复.
- 对于EA/TEF复合体的婴儿,应考虑酸性抑制,以减轻收缩风险.
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