声带息肉患者反流症状指数量表评分、反流体征量表评分、食管动力检测及其与咽喉反流的相关性  

Reflux symptom index,reflux finding score,esophageal motility and their correlation with laryngopharyngeal reflux in patients with vocal cord polyps

作　　者：江重汉 金芬芬 Jiang Chonghan;Jin Fenfen(Department of Otorhinolaryngology,Jiangshan People's Hospital,Jiangshan 324100,Zhejiang Province,China)

机构地区：[1]江山市人民医院耳鼻咽喉科,浙江省324100

出　　处：《中国基层医药》2021年第6期886-890,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省江山市指导性科技计划项目(2018Z3014)。

摘　　要：目的:研究声带息肉患者反流症状指数量表(RSI)评分、反流体征量表(RFS)评分、食管动力检测及其与咽喉反流的相关性,为临床研究提供指导。方法:选取江山市人民医院2018年1月至2020年1月收治的带息肉患者100例声为观察组,另选取同期该院健康体检者100例为对照组进行研究。应用RSI、RFS评分初步诊断咽喉反流情况,监测食管动力分段特点及上下括约肌压力,分析患者RSI、RFS评分、食管动力检测及其与咽喉反流的相关性。结果:观察组35.00%患者RSI评分>13分,30.00%患者RFS评分>7分。观察组RSI评分[(24.17±1.14)分]和RFS评分[(17.59±1.52)分]均明显高于对照组[(7.28±0.12)分、(4.28±0.21)分],差异均有统计学意义(t=147.344、86.742,均P<0.05)。观察组上括约肌松弛恢复时间和持续时间均明显短于对照组,食团内压明显大于对照组,下括约肌长度明显短于对照组,差异均有统计学意义(t=5.373、4.660、2.186、4.977,均P<0.05)。相关性分析显示,患者RSI评分与咽喉异物感、持续清嗓、鼻涕倒流或痰多呈正相关(r=0.640、0.649、0.507,均P<0.05),RFS评分与喉室消失、后连合增生、声带水肿呈正相关(r=0.742、0.516、0.547,均P<0.05)。结论:声带息肉患者RSI、RFS评分与咽喉反流呈正相关,且部分声带息肉患者食管上下括约功能、结构存在一定障碍,存在咽喉反流情况,因此可将三者联合应用于诊断咽喉反流以提高诊断准确率。Objective To investigate reflux symptom index(RSI),reflux finding score(RFS),esophageal motility and to correlate them with laryngopharyngeal reflux in patients with vocal cord polyps,providing guidance for clinical study.Methods A total of 100 patients with vocal cord polyps who received treatment from January 2018 to January 2020 in Jiangshan People's Hospital were included in the observation group.A total of 100 healthy controls who concurrently received physical examination were included in the control group.RSI and RFS were used to preliminarily evaluate laryngopharyngeal reflux.The characteristics of esophageal motility and the pressure of upper and lower sphincter were monitored.The correlation between RSI,RFS,esophageal motility and laryngopharyngeal reflux was analyzed.Results In the observation group,35.00%of patients had RSI>13 points,and 30.00%of patients had RFS>7 points.The RSI and RFS in the observation group were significantly higher than those in the control group[RSI:(24.17±1.14)points vs.(7.28±12)points;RFS:(17.59±1.52)points vs.(4.28±0.21)points,t=147.344,86.742,both P<0.05)].The time to upper sphincter relaxation recovery and the duration of upper sphincter relaxation in the observation group were significantly shorter than those in the control group(t=5.373,4.660,both P<0.05).The intra pellet pressure in the observation group was significantly greater than that in the control group(t=2.186,P<0.05).The length of the lower sphincter in the observation group was significantly shorter than that in the control group(t=4.977,P<0.05).Correlation analysis showed that RSI was positively correlated with foreign body sensation in the throat,continuous throat clearing,nasal reflux or phlegm(r=0.640,0.649,0.507,all P<0.05).RFS was positively correlated with disappearance of laryngeal chamber,posterior commissure hyperplasia and vocal cord edema(r=0.742,0.516,0.547,all P<0.05).Conclusion RSI and RFS of patients with vocal cord polyps are positively correlated with laryngopharyngeal reflux.Some patient

关 键 词：声带 息肉 胃食管反流 食管活动障碍 食管PH监测 食管括约肌 上段 食管括约肌 下段 松弛 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]