咽喉反流和喉占位性病变病因关系的探讨  

Research on the association of laryngeal space occupying lesions and laryngopharyngeal reflux

作　　者：王磊[1] 吴玮[1] 王刚[1] 房居高 徐小杭 刘红丹[1] WANG Lei;WU Wei;WANG Gang;FANG Jugao;XU Xiaohang;LIU Hongdan(Department of Otolaryngology Head and Neck Surgery,Chinese PLA 306th Hospital,Beijing 100101,China)

机构地区：[1]解放军第306医院耳鼻咽喉头颈外科,北京100101 [2]同仁医院耳鼻咽喉头颈外科,北京100730 [3]美国霍普金斯大学分子生物学研究室,3400 Baltimore,Maryland,U.S.A

出　　处：《实用医学杂志》2018年第21期3617-3620,共4页The Journal of Practical Medicine

摘　　要：目的探讨咽喉反流与喉部占位性病变的关系。方法回顾性分析2016年2月至2017年2月在解放军第306医院耳鼻咽喉头颈外科诊断存在喉占位病变的85例患者咽部pH检测(Dx-pH)结果,所有患者均有电子喉镜资料,并进行反流症状指数量表和反流体征量表评分。结果 85例患者中反流症状指数量表和(或)反流体征量表评分阳性率为68%,喉癌及癌前病变组较良性占位病变组量表阳性率及症状、体征评分差异均无统计学意义。咽部p H监测p H <6.5反流阳性率(存在≥1次的反流事件)88%,pH <6.0反流阳性率66%,喉癌及癌前病变组pH <6.5反流阳性率及pH <6.0反流阳性率均较良性占位病变组高。结论咽部p H检测证明喉占位性病变患者具有一定咽喉反流共患率,咽喉反流可能是导致喉部恶性病变的原因之一。本研究中喉癌及癌前病变组病例数有限,还有待于进一步积累数据加以验证。Objective To investigate the relationship between laryngopharyngeal reflux and space occupying lesions of larynx.Methods Eighty-five patients who were diagnosed with laryngeal space occupying lesions in the department of otolaryngology head and neck surgery of Chinese PLA 306th Hospital were enrolled in this retrospective study from February 2016 to February 2017.All the patients were evaluated with reflux symptom index(RSI),reflux finding score(RFS)and 24-hour pharyngeal pH monitoring(Dx-pH),respectively.Results The positive rate of RSI(RSI>13)and/or RFS(RFS>7)was 68%,but with no significant difference in neither the positive rate nor the scores of RSI and RFS between laryngeal carcinoma and premalignant lesion group and benign lesion group.Laryngopharyngeal reflux was determined if there was more than once of appearance of reflux event by using pH<6.5 or pH<6.0 as threshold,respectively.Among all the patients,the positive rate of the pH<6.5 laryngopharyngeal reflux was 88%and the pH<6.0 laryngopharyngeal reflux was 66%.The positive rate of the pH<6.5 and pH<6.0 laryngopharyngeal reflux in laryngeal carcinoma and premalignant lesion group was higher than that in benign lesions group.Conclusions It was proved that there was a strong correlationship between laryngopharyngeal reflux and laryngeal space occupying lesions by using the 24-hour pharyngeal pH monitoring.Laryngopharyngeal reflux may be one of the reasons for malignant laryngeal lesions,which warrants further investigation.

关 键 词：咽喉反流 PH监测 反流症状指数量表 反流体征量表 

分 类 号：R766.5[医药卫生—耳鼻咽喉科] R739.65[医药卫生—临床医学]