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[目的]研究动态食管内pH及胆汁反流检测用于危重症患者胃食管反流的可行性。[方法]收集我院ICU病房2012年1月~2014年1月的危重症患者120例,期间发生胃食管反流患者80例,作为观察组,另选取同期我院内科住院具有反流症状并且进行pH及胆汁反流检测患者50例,作为对照组,利用动态便捷pH检测仪和胆汁检测仪,检测2组反流情况。[结果]观察组单纯酸反流和单纯性胆汁反流发生率分别为10.0%、38.8%,而对照组分别为34.0%,10.0%,2组之间差别具有统计学意义(P<0.05);观察组混合性反流发生率为43.8%低于对照组的56.0%,但是2组之间差异无统计学意义(P>0.05)。观察组病例性反流的63例(78.8%),非病理性反流17例(21.2%)。2组经过24h动态食管pH检测,观察组病理性反流比例为78.8%低于对照组的94.0%,差异具有统计学意义(P<0.05),观察组酸反流次数少于对照组,差异具有统计学意义(P<0.05),观察组反流时间短于对照组以及最长反流时间长于对照组,但是2组之间差异无统计学意义(P>0.05)。观察组胆汁反流次数少于对照组,但是2组之间差异无统计学意义(P>0.05),反流时间和最长反流时间均长于对照组的,2组之间差异具有统计学意义(P<0.05)。[结论]动态食管内pH及胆汁监测不仅应用于普通胃食管反流,而且可应用于危重患者胃食管反流。危重症患者胃反流发生率较高,并且反流时间长,反流量大。
[Objective] To investigate the feasibility of dynamic esophageal pH and bile reflux testing for gastro-esophageal reflux in critically ill patients. [Methods] 120 critically ill patients from January 2012 to January 2014 in ICU ward of our hospital were collected. During the period, 80 patients with gastroesophageal reflux occurred. As the observation group, other hospitalized patients in our hospital also had reflux symptoms Fifty patients with pH and bile reflux were detected. As a control group, two groups of reflux were detected by dynamic pH meter and bile detector. [Results] The incidences of simple acid reflux and simple bile reflux in the observation group were 10.0% and 38.8% respectively, while those in the control group were 34.0% and 10.0% respectively. The differences between the two groups were statistically significant (P <0.05) . The incidence of mixed reflux in the observation group was 43.8% lower than that in the control group (56.0%), but there was no significant difference between the two groups (P> 0.05). In the observation group, 63 cases (78.8%) had reflux and 17 cases (21.2%) had non-pathological reflux. After 24h dynamic esophageal pH test in 2 groups, the rate of pathological reflux was 78.8% in the observation group and 94.0% in the control group, the difference was statistically significant (P <0.05) (P <0.05). The reflux time of the observation group was shorter than that of the control group and the longest reflux time was longer than that of the control group. However, there was no significant difference between the two groups (P> 0.05). The observation group bile reflux frequency less than the control group, but there was no significant difference between the two groups (P> 0.05), reflux time and longest reflux time were longer than the control group, the difference between the two groups with statistics Significance (P <0.05). [Conclusion] Dynamic esophageal pH and bile monitoring not only can be applied to common gastroesophageal reflux but also to gastroesophageal reflux in critically ill patients. The incidence of gastric reflux in critically ill patients is high, and the reflux time is long and the reflux volume is large.