Background

Upper gastrointestinal (GI) symptoms are common in pediatrics, and few prokinetics for children exist. The goal of this study was to determine the efficacy of prucalopride for treatment of upper GI symptoms and feeding difficulties in children.

Methods

This was a retrospective study of patients prescribed prucalopride for upper GI symptoms at a single tertiary care center from July 2019 to January 2021. Demographic data, the indication for prucalopride, comorbidities, and feeding data were recorded. The primary outcome was improvement in the primary upper GI symptom at first follow-up after prucalopride initiation. Univariable and multivariable analyses were used to assess for factors associated with improvement.

Results

The final study population included 71 patients who received prucalopride for treatment of upper GI symptoms. The most common indications were nausea (44%), feeding difficulties (20%), and reflux (11%). Patients had a median age of 16.7 years (range 1.9–21.8 years), and they had received 4 ± 4.8 years of care in our GI clinic and trialed 3.0 ± 2.0 other GI medications by the time of the prucalopride prescription. At follow-up 3.6 ± 2.9 months after the prucalopride was prescribed, 46 patients (65%) had symptomatic improvement of the upper GI symptom. Improvement was more likely in patients with enteral tubes (p = 0.04), pulmonary comorbidities (p = 0.006), and neurologic comorbidities (p = 0.02). Amongst patients with feeding difficulties, 79% of patients showed improvements in oral or tube feeding.

Conclusions

In this sample of children treated for refractory upper GI symptoms at a single tertiary care center, patients showed improvements in symptoms like nausea, reflux, and feeding difficulties after starting prucalopride.

中文翻译：

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普卡必利治疗儿童上消化道症状

背景

上消化道 (GI) 症状在儿科中很常见，并且很少存在儿童促动力剂。本研究的目的是确定普卡必利治疗儿童上消化道症状和喂养困难的疗效。

方法

这是一项回顾性研究，对 2019 年 7 月至 2021 年 1 月在一个三级医疗中心开具普卡必利治疗上消化道症状的患者进行了回顾性研究。记录了人口统计学数据、普卡必利适应症、合并症和喂养数据。主要结果是在开始使用普卢卡必利后首次随访时原发性上消化道症状得到改善。单变量和多变量分析用于评估与改善相关的因素。

结果

最终研究人群包括 71 名接受普卢卡必利治疗上消化道症状的患者。最常见的适应症是恶心 (44%)、喂养困难 (20%) 和反流 (11%)。患者的中位年龄为 16.7 岁（范围 1.9-21.8 岁），他们在我们的胃肠道诊所接受了 4 ± 4.8 年的护理，并在开具普卡必利处方时试用了 3.0 ± 2.0 种其他胃肠道药物。在给予普卢卡必利处方后 3.6 ± 2.9 个月的随访中，46 名患者 (65%) 的上消化道症状出现症状改善。肠管（p  = 0.04）、肺部合并症（p  = 0.006）和神经系统合并症（p = 0.02)。在喂养困难的患者中，79% 的患者经口或管饲有改善。

结论

在这个在单一三级护理中心接受难治性上消化道症状治疗的儿童样本中，患者在开始使用普卢卡必利后表现出恶心、反流和喂养困难等症状的改善。