咽喉反流相关中耳炎1例并文献复习  

A case of otitis media associated with pharyngeal reflux with literature review

作　　者：周莹[1] 王刚[1] 王磊[1] 张晓丽[1] 韩浩伦[1] 李保卫 孙喆喆 吴玮[1] ZHOU Ying;WANG Gang;WANG Lei;ZHANG Xiaoli;HAN Haolun;LI Baowei;SUN Zhezhe;WU Wei(Dapartment of Otolaryngology,the Ninth Medical Centerof Chinses PLA General Hospital,Beijing 100101,China)

机构地区：[1]中国人民解放军总医院第九医学中心耳鼻喉科,北京100101

出　　处：《山东大学耳鼻喉眼学报》2024年第6期131-135,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：战略支援部队特色医学中心学科助推计划(21XK0103)

摘　　要：目的 探讨反流相关中耳炎的临床特点及诊治方案。方法 回顾1例反流相关中耳炎患者病历资料,患者因咳嗽、左耳闷院就诊,行量表评估、pH检测提示咽喉反流,鼓膜穿刺液检测出胃蛋白酶,予以抑酸、改善胃动力、抗过敏、稳定气道、鼻喷激素、促排以及雾化吸入等治疗。结果 3个月后患者症状消失,检测结果正常。检索相关国内外文献分析其发病原因、咽喉反流对气道影响等。结论 在反复发作的分泌性中耳炎、鼻窦炎及慢性肺部疾病中,咽喉反流可能参与其发病过程。Objective To investigate the clinical characteristics,diagnosis and treatment of reflux-associated otitis media.Methods A case of reflux-associated otitis media was reviewed.The patient presented to our hospital with cough and left ear fullness.Laryngo-pharyngeal reflux was suggested by scale evaluation,pH monitoring,and pepsin was detected in tympanic puncture fluid.The patient was treated with acid inhibition,gastric motility improvement,antiallergics,airway stabilisation,nasal hormone spray,evacuation and atomised inhalation.Results Three months later,the patient's symptoms had disappeared and the test results were normal.The relevant national and international literature was searched to analyse the causes of the disease and the effect of laryngo-pharyngeal reflux on the airway.Conclusion Laryngopharyngeal reflux may be involved in the pathogenesis of recurrent secretory otitis media,sinusitis and chronic lung disease.

关 键 词：分泌性中耳炎 咽喉反流性疾病 胃蛋白酶 胃食管反流 PH监测 

分 类 号：R766.5[医药卫生—耳鼻咽喉科] R764.21[医药卫生—临床医学]