下部食道胃接合部括約機構の発達ならびに小児の胃食道逆流現象に関する臨床的研究 : 下部食道pH monitoring 面からの検討

抄録

For the purpose of clarifying a developmental maturation of the lower esophageal sphincteric mechanism, which is a representative of antireflux competence, 47 normal newborn and early infants were examined by 24-hour pH-monitoring in the disital esophagus, and 37 regurgitated infants without organic disturbance and infants and children with gastroesophageal reflux (GER) caused by organic disturbances were also invesitgated. And following results were obtained. 1) It was revealed that physiological maturation of the competence of lower esophageal sphincter would be completed within 3 weeks of life. 2) No significant difference of pH-score calculated from 4 components of pH-data was noted between the position of supine and semi-sitting, resulting from examinations in each position. 3) From comparing normal infants and those with a regurgitation or vomiting, it was demonstrated that ph-monitoring was beneficial to make the precise evaluation of GER. 4) Infants with regurgitation or vomiting were divided into 3 groups according to pH-scoring system, i. e.; A group had no necessity for surgical treatment, C group is having a high need to surgery, and B group consists of infants who need careful investigation because they have a possibility of moving forward C group. 5) For taking the objective decision of surgery in infants with GER, the age factor seemed to be important in addition to pH-score system and symptoms.