喉癌患者并发咽喉反流的初步观察  

Research on the association of the laryngeal carcinoma and laryngopharyngeal reflux

作　　者：赵一馨 张立红[1] 张春芳[2] 王宇光[1] 刁桐湘 李雪实 林裕强 

机构地区：[1] 北京大学人民医院耳鼻咽喉科,100044 [2] 北京大学人民医院临床流行病室,100044

出　　处：《中华耳鼻咽喉头颈外科杂志》2014年第5期356-361,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：首都特色临床医学应用发展项目（z121107001012047）;北京大学人民医院研究与发展基金（RDC2012-03）

摘　　要：目的：探讨喉癌与咽喉反流的关系。方法对31例喉癌与76例对照组（其中36例反流症状和反流体征量表均阴性，40例反流症状指数和/或反流体征评分量表阳性）的一般情况及pH监测参数进行统计学分析。结果喉癌组患者吸烟率80.6％（25/31），与阴性对照组36.1％（13/36）差异有统计学意义（ P＜0.0167），与阳性对照组50.0％（20/40）差异无统计学意义（ P＞0.0167）。喉癌组饮酒率71.0％（22/31），与阴性组36.1％（13/36）差异有统计学意义（ P＜0.0167），与阳性组65.0％（26/40）差异无统计学意义（P＞0.0167）。咽喉反流阳性率，喉癌组、阴性对照和阳性对照组分别为74.2％（23/31）、16.7％（6/36）和52.5％（21/40），食管反流阳性率分别为71.0％（22/31）、52.8％（19/36）和75.0％（30/40）。三组间的咽部阳性率差异有统计学意义（P＜0.05），其中喉癌组与阴性对照组差异有统计学意义（ P ＜0.0167），喉癌组与阳性对照组差异无统计学意义（ P ＞0.0167）。三组间食管阳性率差异无统计学意义（ P＞0.05）。 pH监测参数发现，喉癌组与阴性对照组的咽喉反流次数、直立位咽喉反流次数、咽喉反流总时间、上探头pH＜4时间百分比、长反流次数、咽部DeMeester评分差异均有统计学意义（ P值均＜0.0167），其中喉癌组与阳性对照组的上述指标差异均无统计学意义（ P值均＞0.0167）。结论喉癌患者中咽喉反流阳性率很高，但是咽喉反流阳性喉癌患者中吸烟和/或饮酒的比率也很高，咽喉反流是否为喉癌发病的危险因素，有待继续研究。Objective The objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux .Methods This was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group （ 36 patients ） and positive group （ 40 patients ） by the score of RSI （ reflux symptom index） and RFI （ reflux findings index ） scale.The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed .Results The smoking rate of 80.6%（25/31） in laryngeal carcinoma group was significantly higher than that of （36.1%, P＆lt;0.0167） in the negative group while it did not vary in laryngeal carcinoma group and the positive group （65.0%, P＆gt;0.0167）.The drinking rate of 71.0% （22/31） in laryngeal carcinoma group was higher than that of （36.1%, P＆lt;0.0167） in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group （50.0%, P＆gt;0.0167）.The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group , the positive group, the negative group were 74.2%（23/31）, 16.7%（6/36） and 52.5%（21/40） respectively, which was significantly different （P＆lt;0.05）.The positive rate of gastroesophageal reflux in the three groups above were 71.0% （22/31）, 52.8% （19/36） and 75.0%（30/40）, which had no significant difference （ P＆gt;0.05）.The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group （P＆lt;0.0167） while did not differ in laryngeal carcinoma group and the positive group （ P ＆gt;0.0167）.In the results of 24-hour ambulatory double pH monitoring , there was significant difference in the total and upright reflux number , the total reflux time , the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes

关 键 词：喉肿瘤 癌 鳞状细胞 咽喉反流 喉疾病 

分 类 号：R739.65[医药卫生—肿瘤]