【摘要】 目的探讨研究反流性食管炎伴咽喉疾病的临床表现与分型及其治疗预后。方法选取符合反流性食管炎的诊断标准、有咽喉症状患者,行症状及电子喉镜检查体征量表记分,然后对上述资料进行统计比较分析,并给予质子泵抑制剂(proton pump inhibitor,PPI)等药物或并用手术治疗。结果 167例符合标准的反流性食管炎伴咽喉疾病的患者,反流症状指数量表(reflux symptomindex,RSI)评分>13分者156例,≤13分者11例;最常见症状为咽部异物感,在本组发生率为85.6%。反流检查计分量表(reflux finding score,RFS)评分为阳性者(>7分)148例,≤7分者22例,其中红斑水肿型99例(59.3%),增生型26例(15.6%),混合型(包括上述两型)34例(20.4%),其他患者8例(包括喉部溃疡2例,咽后壁淋巴增生6例)。除12例声带水肿息肉和8例室带肥厚者分别在用药前行摘除和激光烧灼手术治疗外,余147例只采用药物口服治疗,全部患者100%症状缓解,89%的患者治疗8周后症状基本消失,但不同表现类型喉镜下改善不同,其中红斑水肿型89.8%改善,增生型80.8%,混合型74.9%。结论反流性咽喉疾病症状缓解优于体征缓解;虽然从积分上看体征,3种类型治疗效果依次是红斑水肿型>增生型>混合型,但3者之间RSI积分差异不显著。更多还原

【Abstract】 OBJECTIVE To study the types,clinical manifestations and prognosis of laryngopharyngeal reflux disease(LPRD).METHODS We investigated the patients who were diagnosed as reflux esophagitis with pharyngeal and laryngeal symptoms.These symptoms were evaluated by questionnaire(the reflux symptom index,RSI),then the patients underwent videolaryngoscopy and abnormalities were recorded by reflux finding score(RFS) and types were divided.The effects of medical therapy and surgery on these patients were analyzed.RESULTS A total of 167 patients were enrolled in this study.There were 156 patients with RSI scores>13 and 11 patients ≤13.The commonest presented symptom of LPRD was abnormal sensation in the throat(85.6%).There were 145 patients with RFS scores>7 and 22 patients≤7.These cases were mainly divided three types: erythema/edema(99 cases),hyperplasia(26 cases) and mixed type(34 cases),the incidence of those signs were 59.3%,15.6% and 20.4% respectively.In other 8 patients with RFS scores=0,laryngeal ulcer were found in 2 cases and posterior pharyngeal wall cobble stoning in 6 cases.Besides 12 cases of vocal cord edema and 8 cases of ventricular fold hypertrophy being operated by surgery,147 cases were treated with medications.The symptoms were improved in 100% patients and the symptoms were disappeared in 89% patients after 8 weeks of treatment.On laryngoscopy,the improved rate in erythema/edema,hyperplasia and mixed type were 89.8%,80.8% and 74.9% respectively.CONCLUSION To the patients with LPRD,symptoms remission was better than signs improved.Among the 3 types of the patients,the treatment efficacy in erythema/edema type was the best and mixed type was the worst.更多还原