在新生儿中过度使用反流药物
Kevin Ratnasamy1, Shikib Mostamand1
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Stanford University School of Medicine and Stanford Children's Health, Palo Alto, CA, USA.
Seminars in perinatology
|October 11, 2025
概括
在婴儿中诊断胃食道逆流性疾病 (GERD) 是具有挑战性的,导致药物过度使用. 专注于病史,体检和非药物治疗的综合方法对于有效的婴儿GERD管理至关重要.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 新生儿护理 新生儿护理
- 临床诊断 临床诊断 临床诊断
背景情况:
- 在婴儿中,胃食道逆流 (GER) 和胃食道逆流病 (GERD) 的诊断和管理存在重大临床挑战.
- 在NICU的GERD有助于延长停留时间,增加成本和过度使用药物.
研究的目的:
- 为了解决在婴儿中区分GER和GERD的诊断挑战.
- 突出需要改进诊断策略和减少婴儿GERD的药物依赖.
主要方法:
- 对婴儿GERD当前临床指导方针和诊断实践的审查.
- 讨论现有诊断方法的局限性.
- 引入多通道内阻抗-pH监测 (pH/MII) 作为一个客观的诊断工具.
主要成果:
- 目前的指导方针建议减少酸性抑制和更短的经验试验,但婴儿的药物使用仍然很高.
- 诊断方面的挑战包括GER/GERD术语和非特异性症状的互换性使用.
- pH/MII监测可以客观地评估反流发作,内容和症状相关性.
结论:
- 优先考虑详细的病史,体检,以及对怀疑婴儿GERD的食/反流情节的观察.
- 强调包括非药物治疗和共享决策在内的逐步方法.
- 机构管理对于管理婴儿GERD的高价值护理至关重要.
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