缓解期哮喘儿童胃肠动力障碍的临床表现和胃电图改变

摘要

目的 探讨缓解期哮喘患儿胃肠动力障碍的临床表现及胃电图改变.方法 试验组选取缓解期哮喘患儿60例,记录其胃肠动力障碍临床症状,进行胃电图检测.另选取30名健康儿童作为对照组.分别对两组儿童进行餐前、餐后各8 min的胃电图描述,并对各导联餐前、餐后的胃电参数进行分析.结果 试验组均有不同程度的胃肠动力障碍的临床表现,存在纳差者占60.00%,嗳气者占70.00%,恶心、呕吐者占38.33%,66.67%的患儿出现食后腹胀、腹痛,71.67%的患儿存在大便秘结不畅;两组餐后平均幅值(Vpp)、波形反应面积(Ra)较餐前均有所升高,差异有统计学意义(P<0.05);平均频率(f)、正常慢波百分比(PNSW)餐前、餐后无明显差异.试验组的餐前Vpp、f、Ra均低于对照组,差异有统计学意义(P<0.05),餐前胃电参数PNSW与对照组比较,差异无统计学意义.试验组餐后胃电参数Vpp、f、Ra均低于对照组,差异有统计学意义(P<0.05),而餐后胃电参数PNSW两组比较,差异无统计学意义;试验组的餐后/餐前功率比<1,而对照组健康儿童的餐后/餐前功率比>1.结论 缓解期哮喘患儿常有不同程度胃肠动力障碍的临床表现,且伴有胃电活动异常,胃电功率降低,胃电基本节律减慢,胃舒缩功能降低,胃动过缓,胃排空减慢,胃动力不足.%Objective To investigate the clinical symptoms and electrogastrogram variations of gastrointestinal disor-der for children at remission stage of asthma. Methods Sixty children at remission stage of asthma were selected as ex-perimental group, the clinical symptoms of gastrointestinal disorders were recorded, corresponding electrogastrogram was detected, and its gastric electrical parameters were analyzed. Another 30 cases of healthy children were selected as con-trol group. The electrogastrogram preprandial and postprandial 8 min were compared between two groups. Results In experimental group, there were 60. 00% with anorexia, 70. 00% with symptoms of belching, 38. 33% with nausea and vomiting, 66. 67% with postprandial abdominal distension and abdominal pain, and up to 71. 67% with poor constipa-tion symptoms. In two groups, postprandial Vpp and Ra both were increased than those of proprandial. The difference was statistically significant (P<0. 05). There was no significant difference in the gastric electrical parameter f, and PNSW before and after meal. The proprandial Vpp, f, Ra gastric electrical parameters of remission of experimental group were lower than the control group ( P<0 . 05 ) . There was no significant difference in the gastric electrical parame-ters PNSW before meal between two groups. The postprandial Vpp, f, Ra gastric electrical parameters of remission of asthma children series were lower than the control group ( P<0 . 05 ) . There was no significant difference in the gastric electrical parameters PNSW after meal between two groups. Power ratio of before and after meal in experimental group was less 1 . Power ratio of before and after meal in control group was more than 1 . Conclusion Children in the remis-sion stage of asthma often have different degree of the clinical manifestations of gastrointestinal disorders, compared with healthy children electrogastrogram, children in the remission stage of asthma have abnormal gastric electrical activity, gastric electrical power decreases, gastric electrical basic rhythm slows down, bradygastria and diastolic function of the stomach has been slow, gastric emptying delays, gastric motility is insufficiency.