小孩反食流（胃食管反流）主要表现为进食后食物或胃酸反流到口腔或食管，伴随吐奶、频繁呛咳、喂养困难等症状。婴幼儿因消化系统未发育完善，可能出现生理性反流，但若频繁或伴随其他异常，需警惕病理性问题。

Gastroesophageal reflux disease GERD in children is a condition in which liquid flows backward or refluxes out of the stomach and into the esophagus
儿童胃食管反流病 (GERD) 是一种液体从胃倒流或反流到食道的病症
The esophagus is a muscular tube that connects the mouth to the stomach
食道是连接口腔和胃的肌肉管
It passes through a muscle called the diaphragm
它穿过称为隔膜的肌肉,
which separates the chest from the abdomen
它将胸部与腹部分开
The passageway through the diaphragm is a hole called the esophageal hiatus
穿过隔膜的通道是一个称为食管裂孔的孔
The wall of the esophagus has slightly thickened muscle layers where it connects to the stomach
食道壁与胃连接处的肌肉层稍厚
These muscle layers combined with part of the diaphragm form the lower esophageal sphincter
这些肌肉层与部分隔膜结合形成下食管括约肌
Normally when a child swallows food
一般来说,当孩子吞咽食物时,
the lower esophageal sphincter relaxes allowing the food to pass through it
食管下端括约肌放松,让食物通过
Then the lower esophageal sphincter contracts to prevent food from refluxing out of the stomach into the esophagus
然后食管下括约肌收缩,以防止食物从胃回流到食管
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
有时,即使孩子没有吞咽,下食管括约肌也可能放松,从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
这种情况称为胃食管反流,可能没有任何症状或仅有轻度胃灼热
However if the reflux is severe happens often and causes more serious symptoms
然而,如果反流严重、经常发生并导致更严重的症状,
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
胃酸与食物混合会引起刺激
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
进入喉咙并向下进入呼吸道,
irritation and infection of the airways can also happen
气道的刺激和感染也可能发生
Although spitting up is normal
虽然吐奶很正常
GERD may require a procedure called fundoplication
GERD 可能需要一种称为胃底折叠术的手术
Before the procedure the child will be given general anesthesia to put him or her to sleep during the procedure
在手术前,孩子将接受全身麻醉,以便在手术期间让他或她进入睡眠状态
A breathing tube will be inserted through the nose or mouth and down the throat to help the toddler breathe during the procedure
呼吸管将通过鼻子或嘴巴插入喉咙,以帮助幼儿在手术过程中呼吸
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,外科医生会在肚脐附近或肚脐内以及上腹部的左右两侧做五个小切口,
and insert tubes for a camera and surgical instruments
并插入相机和手术器械的管子
Next the surgeon will carefully find the lower esophageal sphincter near the entrance to the stomach
接下来,外科医生会仔细找到靠近胃入口的下食管括约肌
The esophageal hiatus may be tightened with sutures to prevent the stomach from slipping into the chest
可以用缝合线收紧食管裂孔,以防止胃滑入胸部
The top or fundus of the stomach
胃的顶部或底部
will be wrapped around the outside of the sphincter
将包裹在括约肌的外侧
The wrapped fundus will be sutured back on to the stomach to create a valve which tightens and strengthens the sphincter
包裹的胃底将被缝合回胃上以形成一个瓣膜,从而收紧并强化括约肌
The fundoplication valve will help prevent stomach contents from refluxing back up into the esophagus
胃底折叠瓣膜将有助于防止胃内容物反流回食道
In some cases the surgeon may insert a feeding tube
在某些情况下,外科医生可能会插入饲管,
also known as a gastrostomy tube
也称为胃造口管,
into the child's stomach while the sphincter heels
进入孩子的胃,同时括约肌脚后跟
This tube will deliver food directly to the stomach and allow trapped air to escape
该管将食物直接输送到胃中并让滞留的空气逸出
Finally the surgeon will close the incisions with disolvable sutures or skin closure strips
最后,外科医生将用可溶解缝线或皮肤闭合条闭合切口
After the procedure
程序结束后,
the child will be taken to the recovery room for monitoring
孩子将被送往康复室接受监护
Pain medication will be given
将给予止痛药
The child may continue to receive antibiotics through the IV
孩子可能会继续通过静脉注射接受抗生素
Within one to three days the child will be released from the hospital
一到三天内,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
如果孩子有饲管,外科医生会在他或她能够正常进食时将其移除
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