婴幼儿胃食管反流病评估工具的研究进展与临床实践思考

刘若欣; 李荣华; 殷彩欣

doi:10.7499/j.issn.1008-8830.2510025

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中国当代儿科杂志 ›› 2026, Vol. 28 ›› Issue (5) : 636-642. DOI: 10.7499/j.issn.1008-8830.2510025

综述

婴幼儿胃食管反流病评估工具的研究进展与临床实践思考

刘若欣 ¹ (综述) ,
李荣华 ¹ ,
殷彩欣 ² (审校)

作者信息 +

Research progress and clinical practice considerations on assessment tools for gastroesophageal reflux disease in infants and young children

Author information +

文章历史 +

摘要

婴幼儿胃食管反流病（gastroesophageal reflux disease, GERD）是婴幼儿期常见的消化道疾病，其临床表现多样，常与生理性反流和行为表现重叠，致使诊断存在挑战。该文通过系统检索PubMed、Web of Science、中国知网和万方数据等中英文数据库，系统综述了婴幼儿GERD的流行病学特征、临床表现及其对患儿和家庭的影响，重点评价了4种主要评估工具（I⁃GERQ、GSQ⁃I/YC、I⁃GERQ⁃R和GIGER量表）的开发背景、结构特点、信效度及临床应用价值，旨在为婴幼儿GERD的早期识别、标准化评估及个体化管理提供理论依据与实践参考。该文发现I⁃GERQ⁃R具有较高的特异性、良好的信效度和跨文化适用性，是目前推荐用于婴幼儿GERD症状评估与疗效监测的有效工具，GIGER量表在全面筛查方面展现出潜力；未来研究应致力于汉化及开发中文版本婴幼儿GERD问卷并建立多维度评估体系。

Abstract

Gastroesophageal reflux disease (GERD) in infants and young children is a common digestive disorder with diverse clinical manifestations that often overlap with physiological reflux and behavioral expressions, creating diagnostic challenges. Comprehensive searches were conducted in English- and Chinese-language databases, including PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, to review the epidemiological characteristics, clinical presentations, and impacts of GERD on children and their families. Particular emphasis is placed on four principal assessment tools [Infant Gastroesophageal Reflux Questionnaire (I-GERQ), GERD Symptom Questionnaire for Infants/Young Children (GSQ-I/YC), I-GERQ Revised (I-GERQ-R), and Gastrointestinal and Gastroesophageal Reflux Scale for Infants and Toddlers (GIGER)], appraising their development background, structural characteristics, reliability, validity, and clinical application value. The aim is to support early identification, standardized assessment, and individualized management of GERD in infants and young children. Evidence indicates that the I-GERQ-R shows high specificity, good reliability and validity, and cross-cultural applicability, and is currently recommended for symptom assessment and treatment-response monitoring in GERD among infants and young children, while the GIGER scale shows potential for comprehensive screening. Future research should prioritize translation and development of Chinese versions of GERD questionnaires for infants and young children, as well as the establishment of a multidimensional assessment system.

导出引用

刘若欣, 李荣华, 殷彩欣. 婴幼儿胃食管反流病评估工具的研究进展与临床实践思考[J]. 中国当代儿科杂志. 2026, 28(5): 636-642 https://doi.org/10.7499/j.issn.1008-8830.2510025

Ruo-Xin LIU, Rong-Hua LI, Cai-Xin YIN. Research progress and clinical practice considerations on assessment tools for gastroesophageal reflux disease in infants and young children[J]. Chinese Journal of Contemporary Pediatrics. 2026, 28(5): 636-642 https://doi.org/10.7499/j.issn.1008-8830.2510025

参考文献

列表( 原文顺序 | 文献年度倒序 | 文中引用次数倒序 ) 可视化分析

[1]

Rosen

, Vandenplas

, Singendonk

, et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition[J]. J Pediatr Gastroenterol Nutr, 2018, 66(3): 516-554. PMCID: PMC5958910. DOI: 10.1097/mpg.0000000000001889 .

https://www.ncbi.nlm.nih.gov/pubmed/29470322

本文引用 [3]

[2]

Chen

, Vela

, Peterson

, et al. Aga clinical practice update on the diagnosis and management of extraesophageal gastroesophageal reflux disease: expert review[J]. Clin Gastroenterol Hepatol, 2023, 21(6): 1414-1421.e3. DOI: 10.1016/j.cgh.2023.01.040 .

https://www.ncbi.nlm.nih.gov/pubmed/37061897

本文引用 [1]

[3]	Wang LJ, Hu Y, Wang W, et al. Gastroesophageal reflux poses a potential risk for late complications of bronchopulmonary dysplasia: a prospective cohort study[J]. Chest, 2020, 158(4): 1596-1605. DOI: 10.1016/j.chest.2020.05.523 . https://www.ncbi.nlm.nih.gov/pubmed/32450238 本文引用 [1]

[4]	National Collaborating Centre for Women's and Children's Health (UK). Gastro-Oesophageal Reflux Disease: Recognition, Diagnosis and Management in Children and Young People[M]. London: National Institute for Health and Care Excellence (UK), 2015. 本文引用 [2]

[5]	Salvatore S, Agosti M, Baldassarre ME, et al. Cow's milk allergy or gastroesophageal reflux disease: can we solve the dilemma in infants?[J]. Nutrients, 2021, 13(2): 297. PMCID: PMC7909757. DOI: 10.3390/nu13020297 . https://www.ncbi.nlm.nih.gov/pubmed/33494153 本文引用 [1]

[6]	Martin VM, Järvinen KM. Exercising caution with infant diet elimination[J]. J Pediatr Gastroenterol Nutr, 2024, 78(3): 747-748. DOI: 10.1002/jpn3.12122 . https://www.ncbi.nlm.nih.gov/pubmed/38284689 本文引用 [1]

[7]	方浩然, 李中跃. 2018年北美及欧洲小儿胃肠病、肝病和营养协会儿童胃食管反流及胃食管反流病临床指南解读[J]. 中华儿科杂志, 2019, 57(3): 181-186. DOI: 10.3760/cma.j.issn.0578-1310.2019.03.005 . https://www.ncbi.nlm.nih.gov/pubmed/30818894 本文引用 [2]

[8]	Simon M, Levy EI, Vandenplas Y. Safety considerations when managing gastro-esophageal reflux disease in infants[J]. Expert Opin Drug Saf, 2021, 20(1): 37-49. DOI: 10.1080/14740338.2020.1843630 . https://www.ncbi.nlm.nih.gov/pubmed/33115255 本文引用 [1]

[9]	许泱, 吴亚斌. 儿童胃食管反流病的反流阻抗监测特点分析[J]. 重庆医学, 2024, 53(16): 2492-2495, 2502. DOI: 10.3969/j.issn.1671-8348.2024.16.018 . 本文引用 [1]

[10]	Pulvirenti R, Sreeram II, van Wijk MP, et al. Prevalence of gastroesophageal reflux disease in congenital diaphragmatic hernia survivors from infancy to adulthood[J]. J Pediatr Surg, 2024, 59(10): 161593. DOI: 10.1016/j.jpedsurg.2024.06.002 . https://www.ncbi.nlm.nih.gov/pubmed/39004585

[11]

Mills

, Tuffrey

, Tbaily

, et al. Modification of the paediatric gastro-oesophageal reflux disease symptom and quality of life questionnaire (PGSQ) for children with cerebral palsy: a preliminary study[J]. BMJ Paediatr Open, 2024, 8(1): e002256. PMCID: PMC10882336. DOI: 10.1136/bmjpo-2023-002256 .

https://www.ncbi.nlm.nih.gov/pubmed/38378669

本文引用 [1]

[12]	付旭尧. 不同年龄组儿童病理性胃食管反流的临床表现及危险因素分析[D]. 沈阳: 中国医科大学, 2024. 本文引用 [1]

[13]	O'Shea C, Khan R. There is an association between gastro-oesophageal reflux and cow's milk protein intolerance[J]. Ir J Med Sci, 2022, 191(4): 1717-1724. DOI: 10.1007/s11845-021-02757-2 . https://www.ncbi.nlm.nih.gov/pubmed/34590200 本文引用 [1]

[14]

Pulvirenti

, Sortino

, Manti

, et al. Pathogenesis, diagnosis, dietary management, and prevention of gastrointestinal disorders in the paediatric population[J]. Ital J Pediatr, 2022, 48(1): 172. PMCID: PMC9465927. DOI: 10.1186/s13052-022-01366-8 .

https://www.ncbi.nlm.nih.gov/pubmed/36089576

本文引用 [1]

[15]	Vandenplas Y, Orsi M, Benninga M, et al. Infant gastroesophageal reflux disease management consensus[J]. Acta Paediatr, 2024, 113(3): 403-410. DOI: 10.1111/apa.17074 . https://www.ncbi.nlm.nih.gov/pubmed/38116947 本文引用 [1]

[16]

McLoughlin

VZY

, Suaini

NHA

, Siah

, et al. Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore[J]. Ann Acad Med Singap, 2022, 51(5): 263-271. DOI: 10.47102/annals-acadmedsg.2021411 .

https://www.ncbi.nlm.nih.gov/pubmed/35658149

本文引用 [2]

[17]	Curien-Chotard M, Jantchou P. Natural history of gastroesophageal reflux in infancy: new data from a prospective cohort[J]. BMC Pediatr, 2020, 20(1): 152. PMCID: PMC7137340. DOI: 10.1186/s12887-020-02047-3 . https://www.ncbi.nlm.nih.gov/pubmed/32264869 本文引用 [1]

[18]	Singendonk M, Goudswaard E, Langendam M, et al. Prevalence of gastroesophageal reflux disease symptoms in infants and children: a systematic review[J]. J Pediatr Gastroenterol Nutr, 2019, 68(6): 811-817. DOI: 10.1097/MPG.0000000000002280 . https://www.ncbi.nlm.nih.gov/pubmed/31124988 本文引用 [1]

[19]	Sawyer C, Sanghavi R, Ortigoza EB. Neonatal gastroesophageal reflux[J]. Early Hum Dev, 2022, 171: 105600. PMCID: PMC9983357. DOI: 10.1016/j.earlhumdev.2022.105600 . https://www.ncbi.nlm.nih.gov/pubmed/35716649 本文引用 [1]

[20]	Jadcherla SR, Slaughter JL, Stenger MR, et al. Practice variance, prevalence, and economic burden of premature infants diagnosed with GERD[J]. Hosp Pediatr, 2013, 3(4): 335-341. PMCID: PMC4075760. DOI: 10.1542/hpeds.2013-0036 . https://www.ncbi.nlm.nih.gov/pubmed/24435191 本文引用 [1]

[21]	Muller I, Ghio D, Mobey J, et al. Parental perceptions and experiences of infant crying: a systematic review and synthesis of qualitative research[J]. J Adv Nurs, 2023, 79(2): 403-417. PMCID: PMC10100257. DOI: 10.1111/jan.15492 . https://www.ncbi.nlm.nih.gov/pubmed/36373818 本文引用 [1]

[22]	Flatrès C, Aumar M, Ley D, et al. Prevalence of acid gastroesophageal reflux disease in infants with esophageal atresia/tracheoesophageal fistula[J]. Pediatr Res, 2022, 91(4): 977-983. DOI: 10.1038/s41390-021-01510-w . https://www.ncbi.nlm.nih.gov/pubmed/33864015 本文引用 [1]

[23]

Hirsch

, Liu

, Nurko

, et al. Ten-Year trends in pharmacologic management of gastroesophageal reflux disease and pediatric feeding disorders in young children[J]. J Pediatr, 2025, 283: 114628. PMCID: PMC12276995. DOI: 10.1016/j.jpeds.2025.114628 .

https://www.ncbi.nlm.nih.gov/pubmed/40300664

本文引用 [1]

[24]

Bacarreza-Nogales

, Ruiz-Castillo

, Cázares-Méndez

, et al. The consensus of the Asociación Mexicana de Gastroenterología on the diagnosis and treatment of gastroesophageal reflux and gastroesophageal reflux disease in infants[J]. Rev Gastroenterol Mex (Engl Ed), 2024, 89(2): 265-279. DOI: 10.1016/j.rgmxen.2024.04.001 .

https://www.ncbi.nlm.nih.gov/pubmed/38789310

本文引用 [1]

[25]

Sequeira Gomes

, Abraham

, Favara

, et al. Combined multichannel intraluminal impedance and pH testing in infants and young children: a narrative review[J]. Front Pediatr, 2025, 13: 1675149. PMCID: PMC12522203. DOI: 10.3389/fped.2025.1675149 .

https://www.ncbi.nlm.nih.gov/pubmed/41103352

本文引用 [1]

[26]

Arzilli

, Annunziata

, Ernst

, et al. Inter-hospital cardiorespiratory telemonitoring of newborns and infants: a wellworking example of a hub and spoke network[J]. Ital J Pediatr, 2023, 49(1): 5. PMCID: PMC9837930. DOI: 10.1186/s13052-022-01407-2 .

https://www.ncbi.nlm.nih.gov/pubmed/36635722

本文引用 [1]

[27]	Petzoldt J. Systematic review on maternal depression versus anxiety in relation to excessive infant crying: it is all about the timing[J]. Arch Womens Ment Health, 2018, 21(1): 15-30. DOI: 10.1007/s00737-017-0771-4 . https://www.ncbi.nlm.nih.gov/pubmed/28900745 本文引用 [1]

[28]

Aizlewood

, Jones

, Whatmough

. Paediatric gastroesophageal reflux disease and parental mental health: prevalence and predictors[J]. Clin Child Psychol Psychiatry, 2023, 28(3): 1024-1037. PMCID: PMC10280658. DOI: 10.1177/13591045231164866 .

https://www.ncbi.nlm.nih.gov/pubmed/36939301

本文引用 [1]

[29]	Cordray H, Mahendran GN, Tey CS, et al. Severity and prevalence of ankyloglossia-associated breastfeeding symptoms: a systematic review and meta-analysis[J]. Acta Paediatr, 2023, 112(3): 347-357. DOI: 10.1111/apa.16609 . https://www.ncbi.nlm.nih.gov/pubmed/36437565 本文引用 [1]

[30]	McVicar K, Szatkowski L, Ojha S, et al. Exploring parents' experiences, attitudes and understanding of gastro-oesophageal reflux in infants[J]. PLoS One, 2024, 19(9): e0309081. PMCID: PMC11419391. DOI: 10.1371/journal.pone.0309081 . https://www.ncbi.nlm.nih.gov/pubmed/39312535 本文引用 [1]

[31]	Orenstein SR, Cohn JF, Shalaby TM, et al. Reliability and validity of an infant gastroesophageal reflux questionnaire[J]. Clin Pediatr (Phila), 1993, 32(8): 472-484. DOI: 10.1177/000992289303200806 . https://www.ncbi.nlm.nih.gov/pubmed/8403746 本文引用 [1]

[32]	Kleinman L, Rothman M, Strauss R, et al. The infant gastroesophageal reflux questionnaire revised: development and validation as an evaluative instrument[J]. Clin Gastroenterol Hepatol, 2006, 4(5): 588-596. DOI: 10.1016/j.cgh.2006.02.016 . https://www.ncbi.nlm.nih.gov/pubmed/16678075 本文引用 [2]

[33]	Hand P, Olivi G, Gioco G, et al. Bottle-feeding and gastroesophageal reflux disease improvement after restrictive tethered oral tissues release[J]. Eur J Paediatr Dent, 2026, 27(1): 96-104. DOI: 10.23804/ejpd.2023.1817 . https://www.ncbi.nlm.nih.gov/pubmed/37038872 本文引用 [1]

[34]	Pados BF, Basler A. Gastrointestinal symptoms in healthy, full-term infants under 7 months of age[J]. J Pediatr Nurs, 2020, 53: 1-5. DOI: 10.1016/j.pedn.2020.03.011 . https://www.ncbi.nlm.nih.gov/pubmed/32222609

[35]	Patel A, Cirone K, Khoury S, et al. The impact of frenotomy on gastroesophageal reflux in pediatric ankyloglossia: a systematic review[J]. Ann Otol Rhinol Laryngol, 2025, 134(3): 171-178. PMCID: PMC11806641. DOI: 10.1177/00034894241297584 . https://www.ncbi.nlm.nih.gov/pubmed/39529230

[36]	Shaffer AD, Balogun Z, Tobey ABJ, et al. Acid suppression in mild-moderate laryngomalacia without GERD: a randomized controlled trial[J]. Laryngoscope, 2026, 136(1): 471-478. PMCID: PMC12770870. DOI: 10.1002/lary.32471 . https://www.ncbi.nlm.nih.gov/pubmed/40762274

[37]

Slagter

, Raghoebar

, Hamming

, et al. Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study[J]. Clin Oral Investig, 2021, 25(6): 3431-3439. PMCID: PMC8137608. DOI: 10.1007/s00784-020-03665-y .

https://www.ncbi.nlm.nih.gov/pubmed/33315177

本文引用 [1]

[38]

Smith

, Fawkes

, Kotze

, et al. Clinically meaningful difference for the infant gastroesophageal questionnaire revised version (I-GERQ-R): a quantitative synthesis[J]. Patient Relat Outcome Meas, 2020, 11: 87-93. PMCID: PMC7068037. DOI: 10.2147/PROM.S238673 .

https://www.ncbi.nlm.nih.gov/pubmed/32189972

本文引用 [1]

[39]

Sultana

, Hasenstab

, Moore

, et al. Symptom scores and pH-impedance: secondary analysis of a randomized controlled trial in infants treated for gastroesophageal reflux[J]. Gastro Hep Adv, 2022, 1(5): 869-881. PMCID: PMC9615096. DOI: 10.1016/j.gastha.2022.06.004 .

https://www.ncbi.nlm.nih.gov/pubmed/36310566

[40]	Orenstein SR. Symptoms and reflux in infants: infant gastroesophageal reflux questionnaire revised (I-GERQ-R)—utility for symptom tracking and diagnosis[J]. Curr Gastroenterol Rep, 2010, 12(6): 431-436. DOI: 10.1007/s11894-010-0140-1 . https://www.ncbi.nlm.nih.gov/pubmed/20857238 本文引用 [1]

[41]

Duncan

, DiFilippo

, Kane

, et al. Overlapping symptoms of gastroesophageal reflux and aspiration highlight the limitations of validated questionnaires[J]. J Pediatr Gastroenterol Nutr, 2021, 72(3): 372-377. PMCID: PMC9765758. DOI: 10.1097/mpg.0000000000002987 .

https://www.ncbi.nlm.nih.gov/pubmed/33264182

本文引用 [1]

[42]

Deal

, Gold

, Gremse

, et al. Age-specific questionnaires distinguish GERD symptom frequency and severity in infants and young children: development and initial validation[J]. J Pediatr Gastroenterol Nutr, 2005, 41(2): 178-185. DOI: 10.1097/01.mpg.0000172885.77795.0f .

https://www.ncbi.nlm.nih.gov/pubmed/16056096

本文引用 [1]

[43]	Ghaheri BA, Lincoln D, Mai TNT, et al. Objective improvement after frenotomy for posterior tongue-tie: a prospective randomized trial[J]. Otolaryngol Head Neck Surg, 2022, 166(5): 976-984. DOI: 10.1177/01945998211039784 . https://www.ncbi.nlm.nih.gov/pubmed/34491142 本文引用 [1]

[44]	Pados BF, Repsha C, Hill RR. The gastrointestinal and gastroesophageal reflux (GIGER) scale for infants and toddlers[J]. Glob Pediatr Health, 2021, 8: 2333794X211033130. PMCID: PMC8287340. DOI: 10.1177/2333794x211033130 . https://www.ncbi.nlm.nih.gov/pubmed/34350308 本文引用 [1]

[45]	Hill RR, Pados BF. Gastrointestinal symptom improvement for infants following tongue-tie correction[J]. Clin Pediatr (Phila), 2023, 62(2): 136-142. DOI: 10.1177/00099228221117459 . https://www.ncbi.nlm.nih.gov/pubmed/35945826 本文引用 [1]