基层医院诊治胃食管反流性咳嗽的探讨

Diagnosis of gastroesophageal reflux induced cough in primary hospital

目的分析107例胃食管反流性咳嗽(GERC)的临床特征,探讨基层医院诊治本病的方法。方法收集因慢性咳嗽就诊,伴反胃、反酸、胸骨后烧灼感、胸闷疑为GERC的病例,行抗反流诊断性治疗。筛选出有效的107例进行分析,记录患者咳嗽与反流症状、进食、发作时间的关系。结果与有明确进食相关性咳嗽的患者90例,占84.1%,夜间咳嗽患者68例,占63.5%,肥胖患者65例,占60.7%。有反流症状者58例,占54.2%、烧心症状者77例,占71.9%。结论进食相关性咳嗽,夜间咳嗽,肥胖患者,可伴有或不伴有烧心、反酸,对提示GERC的诊断有重要价值。诊断性治疗,可证实诊断。

Objective To investigate clinical features of 107 cases of gastroesophageal reflux（GERC） induced cough to get suitable treatment of the disease in Chinese primary hospital.Methods All out patients with chronic cough treated to sour regurgitation, heartburn and chest congestion were considered as GERC patients and carryed out anti-reflux diagnostic treatment. Selected effectively one hundred and seven cases to analyze the correlation of cough with reflux, feed, and onset time respectively. Results 84.1% of the patients cough were associated with meals（90 cases）, 63.5% of the patients coughed at night（68 cases）, and the fraction of obese patients 60.7%.54.2% of the patients presented reflux symptom and 71.9% presented heartburn （77cases）.Conclusion Cough associated with meals, cough at night or obese patients can be with or without sour regurgitation or heartburn. This has important value for the diagnosis of GERC. Diagnostic treatment can prove this diagnosis.