伴咽喉反流性疾病的声带突肉芽肿的影响因素及治疗效果分析  

The analysis of risk factors and treatment efficacy of vocal process granulomas associated with laryngopharyngeal reflux disease

作　　者：张永丽 赵宇[1] 赵建辉[1] 李奔 吕秋萍[1] 韩红蕾[1] ZHANG Yong-li;ZHAO Yu;ZHAO Jian-hui(Department of Otorhinolaryngology Head&Neck Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院耳鼻喉头颈外科,北京100029 [2]北京协和医学院中国医学科学院,北京100730

出　　处：《中日友好医院学报》2024年第5期264-267,F0003,共5页Journal of China-Japan Friendship Hospital

基　　金：中央高水平医院临床科研业务费;中日友好医院“菁英计划”人才培育工程(ZRJY2024-QMPY19)。

摘　　要：目的:探讨与伴咽喉反流性疾病的声带突肉芽肿相关的危险因素以及抗酸治疗的效果分析。方法:回顾性分析就诊于耳鼻喉门诊的咽喉反流性疾病患者,分为伴有声带突肉芽肿组和不伴有声带突肉芽肿组,对患者的性别、BMI等基本信息和吸烟、饮酒、睡前进食、慢性咳嗽以及用声过度等病史进行单因素和多因素分析。所有患者均接受艾司奥美拉唑镁肠溶片口服治疗2~3个月,保守治疗无效的患者接受显微镜激光手术治疗,术后辅以口服药物治疗至少8周,随诊8~12周。结果:收集120例咽喉反流性疾病患者,性别、BMI、吸烟及饮酒与伴咽喉反流性疾病的声带突肉芽肿具有显著的相关性(P<0.05),其中,男性、BMI>25kg/m^(2)、吸烟、饮酒、喝饮料是咽喉反流性疾病的危险因素。抗胃酸反流治疗对于大部分伴咽喉反流疾病的声带突肉芽肿患者疗效较好,治愈率为93.10%,对于2例抗酸治疗效果欠佳的患者选择显微镜激光手术治疗,术后辅以抗酸治疗仍取得了较好疗效。结论:性别、BMI、吸烟、饮酒以及喝饮料是伴咽喉反流性疾病的声带突肉芽肿重要影响因素。抗酸治疗可作为伴咽喉反流疾病的声带突肉芽肿的首选治疗方案。Objective:To investigate the risk factors for the development of vocal process granulomas associated with laryngopharyngeal reflux disease and evaluate the treatment efficacy of proton pump inhibitors(PPIs).Methods:A total of 120 patients with laryngopharyngeal reflux disease(LPRD)were included in this study.Detailed basic information and medical histories were collected,including age,gender,body mass index(BMI),and lifestyle such as smoking,alcohol consumption,eating habits near bedtime,chronic cough,and frequent vocal strain.We utilized both univariate and multivariate regression analyses to explore the relationships between these factors and vocal process granulomas.Treatment involved an initial course of PPIs for 2-3months,with subsequent micro-laryngeal laser surgery and extended PPI therapy for non-responders.Patient outcomes were assessed at 2-3 months post-intervention.Results:Through chi-square test and logistic regression analysis,significant correlations were identified between vocal process granulomas associated with laryngopharyngeal reflux disease and factors such as gender,BMI,smoking,and alcohol consumption(P<0.05).Key risk factors include being male,having a BMI greater than 25kg/m^(2),smoking and drinking.The administration of PPIs was beneficial for the majority of participants.For individuals who did not initially respond to pharmacological treatment,the sequential approach of micro-laryngeal surgery followed by extended PPI therapy proved to be effective.Conclusion:Gender,BMI,smoking and alcohol consumption are significant influencing factors in the development of vocal process granulomas associated with laryngopharyngeal reflux disease.PPI-based treatment is advisable as a first-line therapy,with surgical intervention reserved for pharmacologically resistant cases.

关 键 词：咽喉反流性疾病 声带突肉芽肿 危险因素 治疗效果 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]