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更新了儿童胃食道逆流性疾病的治疗选择:临床医生的实用指南
Francesco Calabrese1,2, Andrea Pasta1, Luisa Bertin3,4
1Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.
Expert opinion on pharmacotherapy
|November 6, 2025
概括
儿科反流性食道炎 (RE) 需要与成年人不同的年龄特定治疗. 一个逐步的方法,从非药理方法和谨慎的药物使用开始,可以改善结果并最大限度地减少儿童的伤害.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 胃食道逆流性疾病 (GERD) 管理管理
- 在儿童中逆流性食道炎 (RE)
背景情况:
- 儿科反流性食道炎 (RE) 是胃食道反流性疾病 (GERD) 的更广泛范围内的一个独特的实体,在病理生理学,临床表现和治疗风险-益处概况方面与成人呈现有显著差异.
- 迫切需要明确,适合年龄的临床指导方针,以解决儿科患者RE的诊断和管理问题.
研究的目的:
- 综合当前的指导方针和研究结果,诊断和管理儿科反流食道炎.
- 为优化治疗结果提供一个针对年龄的,逐步的策略,同时尽量减少RE儿童的潜在伤害.
主要方法:
- 通过PubMed/Embase搜索确定的指导方针和研究的叙述性审查,直到2025年.
- 关键词包括儿科GERD/RE,诊断方法 (内镜,pH监测,pH阻抗),药物治疗,安全概况和手术干预.
主要成果:
- 诊断方法包括带有活检的内镜和门诊监测 (酸的pH,非酸性逆流的pH阻抗).
- 第一线管理侧重于养优化,加厚剂,过敏评估和位置建议.
- 药物治疗的选择范围从1岁以上的患有食道炎的儿童的质子抑制剂 (PPI) 到H2受体对抗剂,阿尔基纳酸盐,以及对耐火病例的选择性使用 Prokinetics 或 Baclofen. 新兴药物,如竞争性酸阻断剂 (P-CABs) 正在评估中.
结论:
- 建议针对儿科RE采取年龄意识的逐步策略,优先考虑非药物干预,有计划的逐步降低时间有限的PPI和谨慎的附加剂.
- 未来的研究重点包括对P-CABs和alginates的儿科试验,经过验证的抑郁指南的开发,非侵入性生物标志物的识别和可扩展的护理模型.
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