食管动力在咽喉反流发生中的作用  

Role of esophageal motility in the development of laryngopharyngeal reflux

作　　者：马进玉[1] 齐颖[1] 邸岩[1] 苗丽[1] 

机构地区：[1]北京世纪坛医院干部医疗科干一病区,北京市100038

出　　处：《世界华人消化杂志》2009年第34期3543-3546,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨食管动力在咽喉反流发生过程中的作用.方法:对怀疑由胃食管反流引起的22例反流性咽喉炎患者(LPR组)和存在典型食管反流症状(反酸烧心)却没有咽喉炎症状的23例胃食管反流病患者(GERD组)进行食管压力测定和24h食管pH监测.结果:LPR组的食管上括约肌压力(UESP)和距食管下括约肌(LES)8cm处的食管收缩力明显低于GERD组(41.23±19.61mmHgvs55.82±20.51mmHg;58.77±30.84mmHgvs77.40±36.12mmHg,P=0.009,0.035),2组的食管上括约肌长度(UESL)、食管下括约肌长度(LESL)、食管下括约肌压力(LESP)和食管其余各段(距LES3、13、18cm)的收缩力无明显差异.LPR组病理性酸反流的发生率明显低于GERD组(χ2=3.979,P=0.046),差异有统计学意义.结论:UESP和食管下段的收缩力在阻止咽喉反流的发生中起重要作用.AIM： To evaluate the role of esophageal motility in the development of laryngopharyngeal reflux.METHODS： Esophageal manometry and 24-hour esophageal pH monitoring were performed in 22 patients suffering from reflux laryngitis （LPR group） caused by gastroesophageal reflux and 23 patients with typical gastroesophageal reflux symptoms （acid regurgitation and heartburn） but without laryngitis-related symptoms （GERD group）. RESULTS： The upper esophageal sphincter （UES） pressure and the contractile force of esophageal segment 8 cm above the lower esophageal sphincter （LES） in the LPR group were significantly lower than those in the GERD group （41.23 ± 19.61 mmHg vs 55.82 ±20.51 mmHg, P = 0.009; 58.77± 30.84 mmHg vs 77.40 ±36.12 mmHg, P = 0.035）. No significant differences were noted in UES length, LES length,LES pressure and the contractile force of the remaining segments of the esophagus （3, 13, and 18 cm above LES） between the two groups. The incidence of pathological acid reflux in the LPR group was significantly lower than that in the GERD group （X^2 = 3.979, P = 0.046）. CONCLUSION： UESP and the contractile force of the lower esophagus play an important role in preventing the development of laryngopharyngeal reflux.

关 键 词：胃食管反流 咽喉反流 食管测压 24-小时食管pH监测 

分 类 号：R766[医药卫生—耳鼻咽喉科]