经胃镜检查发现的咽喉部疾病的临床分析  

Clinical analysis of throat diseases found by gastroscopy

作　　者：高福生[1] 张川[1] 展玉涛[1] Gao Fusheng;Zhang Chuan;Zhan Yutao(Department of Gastroenterology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院消化内科,北京100730

出　　处：《中国医刊》2022年第10期1081-1085,共5页Chinese Journal of Medicine

基　　金：北京市医管局消化协同中心特色项目(XXT09)。

摘　　要：目的探讨胃镜对于咽喉部疾病的诊治价值以及经胃镜检查发现的咽喉部疾病的相关危险因素。方法分析2021年1月1日至12月31日在首都医科大学附属北京同仁医院进行胃镜检查2475例患者的临床资料,根据胃镜观察咽喉部有无症状分为有症状组(227例)和无症状组(2248例)。使用内镜窄带成像术(narrow band imaging,NBI)联合放大胃镜对普通胃镜不能明确病变性质的咽喉部黏膜异常诊断,并与病理学诊断结果进行比较。采用logistic回归分析胃镜发现的咽喉部疾病的相关危险因素。结果胃镜对咽喉部疾病的总检出率为2.30%(57/2475)。有症状组患者咽喉部疾病胃镜检出率(19.38%)高于无症状组(0.58%),差异有显著性(χ^(2)=324.05,P<0.05)。NBI联合放大胃镜对咽喉部病变的诊断与病理学诊断结果的符合率为91.7%。单因素logistic回归分析显示,年龄≥60岁、吸烟、饮酒、咽喉部反流是经胃镜检查发现的咽喉部疾病的危险因素(P<0.05)。结论常规胃镜检查应详细观察咽喉部,对存在咽喉部症状的患者尤其应该予以关注。老年、吸烟、饮酒、咽喉部反流是发生咽喉部疾病的高危因素,常规胃镜检查时应留意此类患者的咽喉部状况。Objective To explore the clinical value of gastroscopy in the diagnosis and treatment of throat diseases together with the related risk factors of throat diseases found by gastroscopy.Method Total 2475 patients who underwent gastroscopy in Beijing Tongren Hospital,Capital Medical University from January 1,2021 to December 31,2021 were selected.The results of gastroscopy and detailed observation of throat were obtained.The gastroscopic detection of throat diseases in the two groups with and without throat symptoms were analyzed;Narrow band imaging(NBI)magnifying gastroscopy cannot clearly diagnose the nature of the lesion and the coincidence with the pathological diagnosis.Analyses involve the situation of gastroscopic detection regarding the throat diseases in the throat symptoms group,as well the asymptomatic group.The diagnosis of abnormal lesions of the throat mucosa by Narrow band imaging(NBI)magnifying gastroscopy as the nature of the lesions cannot be determined by ordinary gastroscopy,and its compliance with the pathological diagnosis.The risk factors related to throat diseases found by gastroscopy.Result The total detection rate of pharyngeal and laryngeal diseases by gastroscopy was 2.30%(57/2475).The gastroscopy detection rate of throat diseases in symptomatic group was higher than that in asymptomatic group(19.38%and 0.58%,respectively,χ^(2)=324.05,P<0.05).The coincidence rate on the diagnosis of pharyngeal and laryngeal lesions by NBI magnifying gastroscopy and pathological diagnosis was 91.7%(11/12).Binary logistic regression analysis showed that age≥60 years old,smoking,drinking and throat reflux were the risk factors of throat diseases(P<0.05).Conclusion Routine gastroscopy should observe the throat in detail,especially for patients with throat symptoms.Old,smoking,drinking and throat reflux are high risk factors for throat diseases.

关 键 词：胃镜 窄带成像 放大胃镜 咽部疾病 喉部疾病 危险因素 

分 类 号：R766.1[医药卫生—耳鼻咽喉科]