反流性喉炎与声带白斑关系的初步探讨  

The Potential Relationship between Reflux Laryngitis and Vocal Leukoplakia

作　　者：庄佩耘[1] 周莉[1] 郝玲[1] 张帆[2] 郭永清[1] 蒋家琪[2] 

机构地区：[1]厦门大学附属中山医院耳鼻咽喉科,厦门361004 [2]复旦大学附属眼耳鼻喉科医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2010年第5期448-452,共5页Journal of Audiology and Speech Pathology

摘　　要：目的探讨反流性喉炎与声带白斑的关系。方法2009年3月~2009年11月在厦门大学附属中山医院耳鼻咽喉科经临床和病理诊断为声带白斑同时合并反流性喉炎的8例患者,予以6~8周的质子泵抑制剂（PPI）抗反流治疗,治疗前后分别进行频闪喉镜检查、嗓音主客观声学评估、嗓音障碍指数以及反流性喉炎症状评分量表和体征发现量表的评估。结果8例患者反流性喉炎均治愈,频闪喉镜、主客观声学分析结果显示治疗后较治疗前均有所改善;8例患者声带白斑完全消失,随诊3~5个月未见声带白斑复发。结论反流性喉炎与声带白斑可能存在某种关联,其在声带白斑的发生发展中起一定的作用,临床中应注意对声带白斑患者进行反流性喉炎的评估,PPI治疗可使部分患者避免手术。Objective To explore the potential relationship between vocal leukoplakia and reflux laryngitis.Methods Eight cases diagnosed both clinically and histologically as vocal leukoplakia with concomitant reflux laryngitis were recruited from Department of Otolaryngology,Zhongshan Hospital affiliated to Xiamen University between March 2009 and December 2009.Reflux laryngitis was treated with a proton pump inhibitor combined with voice and behavior therapy for six to eight weeks.Evaluation was completed before and after treatment with the ESL evaluation protocol and stroboscopic,perceptual and acoustical（MDVP） evaluations,the VHI-10 questionnaire,a reflux laryngitis finding score and a symptom index form.Results Following anti-reflux treatment,all eight patients were free from leukoplakia and presented almost normal voices,no recurrence was observed during the 3~5 months follow-up.Conclusion There is a potential relationship between vocal leukoplakia and reflux laryngitis,the latter maybe plays a synergic role on the former.Clinically,the evaluation and diagnostic assessment of reflux laryngitis might be done for the patients with vocal leukoplakia,for those with concomitant well diagnosed or suspected reflux laryngitis should be treated with acid suppressive therapies,some of patients with vocal leukoplakia might be recovered or improved without surgical procedures.

关 键 词：声带白斑 反流性喉炎 质子泵抑制剂治疗 嗓音疾病评估 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]