小儿慢性咽喉炎与胃食管反流的关系

Chronic laryngopharyngeal inflammation associated with gastroesophageal reflux in children

目的探讨小儿慢性咽喉炎与胃食管反流(GER)的关系。方法对37例慢性咽喉炎患儿进行24h食管pH监测,30例无症状儿作为对照。结果病例组各项食管酸反流指标如酸反流次数、反流≥5min次数、最长反流时间、酸性反流指数及Boix-Ochoa综合评分均高于对照组,差异有统计学意义(Z=2.673～4.144,P均<0.01)。病例组GER检出率(40.5%,15/37例)高于对照组(3.3%,1/30例),差异有统计学意义(χ2=12.617,P<0.01)。结论GER与小儿慢性咽喉炎关系密切;对常规治疗效果差的慢性咽喉炎患儿要考虑到GER的可能,及时进行有关检测。

Objectives To investigate the relationship between chronic laryngopharyngeal inflammation and gastroesophageal reflux （GER） in children. Methods Twenty-four-hour esophageal pH monitoring was performed in 37 cases （patient group） with chronic refractory laryngopharyngeal inflammation （〉 4 weeks）, and 30 asymptomatic chil- dren served as control group. Results Each parameter of esophageal acid reflux in patient group such as the episodes of acid reflux, the frequency of reflux longer than 5 min, the longest reflux time （min） , the percentage time of pH 〈 4 and Boix-Ochoa score were significantly higher than that in control group （all P 〈 0.01） . According to the diagnostic criteria of pathological GER （Boix-Ochoa score 〉 11.99 and reflux index ≥ 4.0%）, pathological GER was detected in 40.5% （15/37） of patients with chronic laryngopharyngeal inflammation, while it was 3.3% （1/30） in control. There is statistical significance between the two groups （Х^2 = 12.617, P 〈 0.01 ） . Conclusions It suggests that GER is closely related to chronic refractory laryngopharyngeal inflammation in children. When routine treatment to childhood chronic laryngopharyngeal inflammation fails, GER may be considered for differential diagnosis.