https://scholars.lib.ntu.edu.tw/handle/123456789/439013
標題: | Combined multichannel intraluminal impedance and pH monitoring assists the diagnosis of sliding hiatal hernia in children with gastroesophageal reflux disease | 作者: | JIA-FENG WU WEI-CHUNG HSU PING-HUEI TSENG HSIU-PO WANG HONG-YUAN HSU MEI-HWEI CHANG YEN-HSUAN NI |
公開日期: | 2013 | 卷: | 48 | 期: | 11 | 起(迄)頁: | 1242-1248 | 來源出版物: | Journal of Gastroenterology | 摘要: | Background: The role of combined multichannel intraluminal impedance and pH monitoring (MII-pH) in diagnosing sliding hiatal hernia in gastroesophageal reflux disease (GERD) children remains unclear. We aimed to explore the clinical efficacy of MII-pH as a supplement diagnostic method for sliding hiatal hernia. Methods: A total of 104 symptomatic GERD children [mean ± standard deviation (SD) age = 4.5 ± 5.5 years] were recruited. All of them were diagnosed as GERD with and without sliding hiatal hernia by barium and/or esophagogastroduodenoscopy study. All subjects received 24 h MII-pH monitoring to test the efficacy of this new modality. Results: Sixteen children were diagnosed to have sliding hiatal hernia, and nine (56.3 %) of them received fundoplication. None of non-hiatal hernia children were indicated for fundoplication [risk difference (RD) 0.56; P < 0.001]. Impedance probes detected more reflux episodes than pH-probe in the whole study population (mean ± SD = 62.1 ± 47.8 vs. 47.8 ± 48.1 episodes; P = 0.02, paired t test). Due to the presence of pH-only reflux, the reflux episodes detected by impedance probes is less than that by pH probe in sliding hiatal hernia children (mean ± SD = 49.2 ± 78.9 vs. 103.7 ± 60.4 episodes; P = 0.01, paired t test). Ratio of reflux episodes detected by pH-probe to that by impedance probes >1 was more frequently noted in sliding hiatal hernia children than non-sliding hiatal hernia children (Odds ratio 58.33, P < 0.001). The sensitivity and specificity of this diagnostic tool to predict sliding hiatal hernia in GERD children are 93.8 and 79.6 %, respectively. Conclusions: Ratio of reflux episodes detected by pH-probe to that by impedance probes >1 demonstrated by MII-pH study is a good screening test of sliding hiatal hernia in GERD children. ? 2013 Springer Japan. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84889883616&doi=10.1007%2fs00535-013-0750-0&partnerID=40&md5=016ac2ab43081a80c9090b1ec19c9bc6 https://scholars.lib.ntu.edu.tw/handle/123456789/439013 |
ISSN: | 0944-1174 | DOI: | 10.1007/s00535-013-0750-0 | SDG/關鍵字: | barium; article; child; clinical effectiveness; combined multichannel intraluminal impedance; contrast enhancement; controlled study; esophagogastroduodenoscopy; esophagus ulcer; female; gastric pH monitoring; gastroesophageal reflux; heartburn; hiatus hernia; human; impedance; major clinical study; male; neurologic disease; preschool child; priority journal; reflux esophagitis; respiratory tract disease; sensitivity and specificity; stomach fundoplication; symptomatology; upper gastrointestinal tract; vomiting; Adolescent; Child; Child, Preschool; Electric Impedance; Esophageal pH Monitoring; Female; Fundoplication; Gastroesophageal Reflux; Hernia, Hiatal; Humans; Hydrogen-Ion Concentration; Infant; Male; Predictive Value of Tests; Sensitivity and Specificity; Signal Processing, Computer-Assisted |
顯示於: | 醫學教育暨生醫倫理學科所 |
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