成年人咽喉反流与分泌性中耳炎的相关性研究  

Correlation between Laryngopharyngeal Reflux and Secretory Otitis Media in Adults

作　　者：汤智平 陈庆利 邱若庆 沈康 罗瑶 吴湘萍 Tang Zhiping;Chen Qingli;Qiu Ruoqing;Shen Kang;Luo Yao;Wu Xiangping(Department of Otolaryngology,Dongguan Kanghua Hospital Dong Guan,523080,China)

机构地区：[1]东莞康华医院耳鼻咽喉科,东莞523080

出　　处：《听力学及言语疾病杂志》2018年第2期159-161,共3页Journal of Audiology and Speech Pathology

摘　　要：目的探讨咽喉反流(laryngopharyngeal reflux,LPR)与分泌性中耳炎(secretory otitis media,SOM)的相关性。方法对294例有LPR相关症状的成年患者行反流症状指数评分量表(reflux symptom index,RSI)、反流体征评分量表(reflux finding score,RFS)评估及声导抗测试,对其中54例B型鼓室导抗图者行鼓膜穿刺抽液,分析其结果。结果 294例受试者中,RSI<13分者168例(A、C、B型鼓室导抗图者分别为128、31、9例),RSI>13分者126例(A、C、B型鼓室导抗图者分别为52、29、45例);RFS<7分者172例(A、C、B型鼓室导抗图者分别为131、32、9例)、RFS>7分者122例(A、C、B型鼓室导抗图者分别为49、28、45例),RSI>13分及RFS>7分者中B型鼓室导抗图者所占比例分别大于RSI<13分及RFS<7分者,差异有统计学意义(P<0.05)。A、C、B型鼓室导抗图者RSI评分分别为8.6±3.8、15.9±7.5、23.9±8.6分,RFS评分分别为5.6±2.6、9.6±4.7、15.3±6.6分,与A、C型者比较,B型者RSI、RFS评分较高,差异有统计学意义(P<0.05)。54例B型鼓室导抗图者中,RSI<13分者的鼓室积液中浆液、粘液、胶样液分别为6例、2例、1例,RSI>13分者的鼓室积液中浆液、粘液、胶样液分别为13例、23例、9例,RSI<13分者鼓室积液以浆液性为主,RSI>13分者的鼓室积液以粘液性为主,差异有统计学意义(P<0.05)。结论LPR与SOM有一定的相关性,LPR可能会加快SOM的病程进展。Objective To study the correlation between laryngopharyngeal reflux(LPR)and secretory otitis media(SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index(RSI)and reflux finding score(RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI<13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI>13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patients,172 patients showed RFS<7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS>7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI>13 and RFS>7 were both significantly higher than those in the patients with RSI<13 and RFS<7(P<0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6±3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score(P<0.05).Among the 54 patients of type B tympanograms,those with RSI<13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI>13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI<13 were mainly serous,while those with the RSI>13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPR may accelerate the progress of SOM.

关 键 词：咽喉反流 分泌性中耳炎 反流症状指数评分量表 反流体征评分量表 鼓室导抗图 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]