窄带成像技术在咽喉反流诊断中的优势应用  

Narrow band imaging might contribute to the diagnosis of laryngopharyngeal reflux

作　　者：吴迪盼盼 崔新华[2] 郭颖[2] 耿博[2] 高芳芳 梁辉[2] WU Dipanpan;CUI Xinhua;GUO Ying;GENG Bo;GAO Fangfang;LIANG Hui(Liaocheng People̓s Hospital,Liaocheng 252000,Shandong,China;Department of Otorhinolaryngology&Head and Neck Surgery,The First Affiliated Hospital of Shandong First Medical Universi-ty,Jinan 250014,Shandong,China)

机构地区：[1]聊城市人民医院,山东聊城252000 [2]山东第一医科大学第一附属医院(山东省千佛山医院)耳鼻咽喉头颈外科,山东济南250014

出　　处：《山东大学耳鼻喉眼学报》2021年第3期31-36,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：济南市科技局临床医学科技创新计划(201907062)。

摘　　要：目的探讨窄带成像技术(NBI)在咽喉反流(LPR)诊断中的作用。方法根据我国2015年咽喉反流性疾病诊断与治疗专家共识的标准招募39例咽喉反流阳性患者(LPR组)和19例阴性对照,参与者均完成反流症状指数评分量表(RSI)和反流体征评分量表(RFS)评分及NBI下的电子喉镜检查。结果39例LPR患者中2例失访。与共识的标准比较,NBI技术灵敏度是94.6%,特异性是78.9%(Kappa=0.755,P<0.001)。治疗前:LPR组NBI阳性率为94.6%,RFS的阳性率为94.6%,对照组NBI阳性率为21.1%,RSI的阳性率为24.3%。LPR组NBI阳性率与RFS阳性率一致且有统计学意义(P=0.003),与RSI阳性率存在差异,且二者结论一致性较差(P=0.040)。LPR组与对照组阳性率不同,差异有统计学意义(P<0.001)。治疗后:仅21例LPR患者参与复查。NBI下的阳性率为71.4%,RSI阳性率为9.5%,二者结论一致性较差(P<0.001)。RFS阳性率为61.9%,与NBI相对比一致性好(Kappa=0.576,P=0.007)。21例随访患者治疗前后阳性率由90.5%下降为71.4%,差异无统计学意义(P=0.119)。结论NBI技术具有较好的诊断咽喉反流的价值。Objective To explore the possible role of narrow band imaging(NBI)in the diagnosis of laryngopharyngeal reflux(LPR).Methods According to the Chinese domestic expert consensus on the diagnosis and treatment of laryngopharyngeal reflux(LPR),we recruited 39 LPR patients who visited our outpatient department.All patients were assessed using the reflux symptom index(RSI)and questionnaires on the reflux finding score(RFS)and NBI endoscopy before and after treatment.At the same time,we selected 19 symptom-negative controls and completed the above examinations.Results Initially,we recruited 39 LPR-positive patients,although two were lost.Compared with the consensus standard,the sensitivity of NBI was 94.6%,its specificity was 78.9%,(Kappa=0.755,P<0.001).Before treatment:According to NBI,the positivity rate was 94.6%.In the control group,the positivity rate was 21.1%.The positivity rates based on RSI and RFS were 24.3%and 94.6%,respectively.The results showed that NBI was as effective as RFS(P=0.003),and the consistency between NBI and RSI was poor(P=0.040).The positivity rate of the study group was significantly different from that of the control group(P<0.001).After treatment,only 21 patients with LPR agreed to undergo post-treatment.The positivity rate of NBI was 71.4%,while that of RSI was 9.5%,indicating poor consistency(P<0.001).The positivity rate of RFS was 61.9%,which was relatively better than that of NBI(Kappa=0.576,P=0.007),showing statistical significance.Compared with the pre-study,the positive rate dropped from 90.5%to 71.4%,although the difference was not statistically significant(P=0.119).Conclusion NBI is valuable for LPR diagnosis.

关 键 词：咽喉反流 窄带成像 诊断 微血管成像 反流症状指数评分量表 反流体征评分量表 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]