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小孩反食流（胃食管反流）主要表現(xiàn)為進食后食物或胃酸反流到口腔或食管，伴隨吐奶、頻繁嗆咳、喂養(yǎng)困難等癥狀。嬰幼兒因消化系統(tǒng)未發(fā)育完善，可能出現(xiàn)生理性反流，但若頻繁或伴隨其他異常，需警惕病理性問題。

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Gastroesophageal reflux disease GERD in children is a condition in which liquid flows backward or refluxes out of the stomach and into the esophagus
兒童胃食管反流病 (GERD) 是一種液體從胃倒流或反流到食道的病癥
The esophagus is a muscular tube that connects the mouth to the stomach
食道是連接口腔和胃的肌肉管
It passes through a muscle called the diaphragm
它穿過稱為隔膜的肌肉,
which separates the chest from the abdomen
它將胸部與腹部分開
The passageway through the diaphragm is a hole called the esophageal hiatus
穿過隔膜的通道是一個稱為食管裂孔的孔
The wall of the esophagus has slightly thickened muscle layers where it connects to the stomach
食道壁與胃連接處的肌肉層稍厚
These muscle layers combined with part of the diaphragm form the lower esophageal sphincter
這些肌肉層與部分隔膜結(jié)合形成下食管括約肌
Normally when a child swallows food
一般來說,當(dāng)孩子吞咽食物時,
the lower esophageal sphincter relaxes allowing the food to pass through it
食管下端括約肌放松,讓食物通過
Then the lower esophageal sphincter contracts to prevent food from refluxing out of the stomach into the esophagus
然后食管下括約肌收縮,以防止食物從胃回流到食管
Sometimes the lower esophageal sphincter may relax even when the child hasn't swallowed allowing food already in the stomach to move back into the esophagus
有時,即使孩子沒有吞咽,下食管括約肌也可能放松,從而使胃中已有的食物返回食管
This condition is called gastroesophageal reflux and may have no symptoms or only mild heartburn
這種情況稱為胃食管反流,可能沒有任何癥狀或僅有輕度胃灼熱
However if the reflux is severe happens often and causes more serious symptoms
然而,如果反流嚴(yán)重、經(jīng)常發(fā)生并導(dǎo)致更嚴(yán)重的癥狀,
the child has a condition called gastroesophageal reflux disease or GERD
孩子患有胃食管反流病 (GERD)
If the food refluxes into the esophagus
如果食物反流到食道,
stomach acid mixed with the food can cause irritation
胃酸與食物混合會引起刺激
If the food refluxes all the way up the esophagus
如果食物一直逆流到食道
into the throat and down into the airways
進入喉嚨并向下進入呼吸道,
irritation and infection of the airways can also happen
氣道的刺激和感染也可能發(fā)生
Although spitting up is normal
雖然吐奶很正常
GERD may require a procedure called fundoplication
GERD 可能需要一種稱為胃底折疊術(shù)的手術(shù)
Before the procedure the child will be given general anesthesia to put him or her to sleep during the procedure
在手術(shù)前,孩子將接受全身麻醉,以便在手術(shù)期間讓他或她進入睡眠狀態(tài)
A breathing tube will be inserted through the nose or mouth and down the throat to help the toddler breathe during the procedure
呼吸管將通過鼻子或嘴巴插入喉嚨,以幫助幼兒在手術(shù)過程中呼吸
Commonly the surgeon will make five tiny incisions near or in the belly button and on the right and left sides of the upper abdomen
通常,外科醫(yī)生會在肚臍附近或肚臍內(nèi)以及上腹部的左右兩側(cè)做五個小切口,
and insert tubes for a camera and surgical instruments
并插入相機和手術(shù)器械的管子
Next the surgeon will carefully find the lower esophageal sphincter near the entrance to the stomach
接下來,外科醫(yī)生會仔細(xì)找到靠近胃入口的下食管括約肌
The esophageal hiatus may be tightened with sutures to prevent the stomach from slipping into the chest
可以用縫合線收緊食管裂孔,以防止胃滑入胸部
The top or fundus of the stomach
胃的頂部或底部
will be wrapped around the outside of the sphincter
將包裹在括約肌的外側(cè)
The wrapped fundus will be sutured back on to the stomach to create a valve which tightens and strengthens the sphincter
包裹的胃底將被縫合回胃上以形成一個瓣膜,從而收緊并強化括約肌
The fundoplication valve will help prevent stomach contents from refluxing back up into the esophagus
胃底折疊瓣膜將有助于防止胃內(nèi)容物反流回食道
In some cases the surgeon may insert a feeding tube
在某些情況下,外科醫(yī)生可能會插入飼管,
also known as a gastrostomy tube
也稱為胃造口管,
into the child's stomach while the sphincter heels
進入孩子的胃,同時括約肌腳后跟
This tube will deliver food directly to the stomach and allow trapped air to escape
該管將食物直接輸送到胃中并讓滯留的空氣逸出
Finally the surgeon will close the incisions with disolvable sutures or skin closure strips
最后,外科醫(yī)生將用可溶解縫線或皮膚閉合條閉合切口
After the procedure
程序結(jié)束后,
the child will be taken to the recovery room for monitoring
孩子將被送往康復(fù)室接受監(jiān)護
Pain medication will be given
將給予止痛藥
The child may continue to receive antibiotics through the IV
孩子可能會繼續(xù)通過靜脈注射接受抗生素
Within one to three days the child will be released from the hospital
一到三天內(nèi),孩子就能出院了
If the child has a feeding tube the surgeon will remove it when he or she is able to eat normally
如果孩子有飼管,外科醫(yī)生會在他或她能夠正常進食時將其移除