在早产婴儿的胃食道逆流和呼吸暂停
1Professor of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia.
Seminars in perinatology
|September 23, 2025
概括
胃食道逆流 (GER) 和呼吸暂停在早产婴儿中很常见. 由于研究的局限性,目前将GER与早产性呼吸暂停的原因联系在一起的证据很弱.
科学领域:
- 新生儿生理学 新生儿生理学
- 儿科胃肠病学 儿科胃肠病学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 呼吸暂停和胃食道逆流 (GER) 在早产婴儿 (<32周妊娠年龄) 中非常普遍.
- 过早的呼吸暂停源于不成熟的呼吸控制,可能涉及喉化学反射.
- 一个假设表明GER和新生儿的呼吸暂停之间存在联系,与老年婴儿的咳反射形成鲜明对比.
研究的目的:
- 评估目前关于胃食道逆流作为早产性呼吸暂停的致病因素的证据.
- 确定未来研究的挑战和要求,研究早产婴儿的GER-呼吸暂停关系.
主要方法:
- 审查现有研究,检查GER和早产性呼吸暂停之间的关系.
- 分析先前研究的方法限制,包括研究设计,测量技术,终点和患者异质性.
主要成果:
- 现有证据支持GER作为早产性呼吸暂停的原因,目前被认为是不充分的.
- 多项研究未能确立明确的因果关系,往往是由于方法上的重大缺陷.
结论:
- 未来的研究需要精确选择患者,准确测量酸性和非酸性逆流事件,并标准化心肺呼吸系统终点.
- 确定特定的早产婴儿子组,其中GER显著影响呼吸控制障碍,需要严格的研究设计.
相关概念视频
Breathing
64.2K
The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
64.2K
Sleep Apnea
483
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
483
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
1.3K
Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
1.3K
Gastroesophageal Reflux Disease II: Clinical Features and Management
705
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
705
Esophageal Strictures-I: Introduction
651
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
651
Respiratory Volumes and Capacities I
1.6K
Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...
1.6K


