咽异物感伴有咽喉反流患者抗反流治疗的临床观察

Clinical observation of anti-reflux treatment in patients with pharyngealforeign body sensation complicated with laryngopharyngeal reflux

目的观察抗反流治疗对咽异物感伴有咽喉反流的临床疗效。方法将门诊以咽异物感自评超过3分,患病1个月以上的患者,进行反流症状指数量表(RSI)及反流临床表现量表(RFS)评分,对RSI超过13分及RFS超过7分的患者进行抗反流治疗,以能持续治疗8周以上为有效观察对象,共104例。分析入组患者反流各症状发生率、反流临床表现各体征发生率,并进行疗效评定。结果 104例咽异物感患者多有反流症状清嗓动作(92/104,88.46%),主要反流体征为后连合肥厚(97/104,93.27%),红斑/充血(89/104,85.57%),喉内黏稠分泌物(87/104,83.65%),喉室阻塞(73/104,70.19%)等,经抗反流治疗,有效61例,有效率为58.65%;RSI治疗前后比较,差异有统计学意义(t=1.975,P<0.05);RFS治疗前后比较,差异无统计学意义(t=1.258,P>0.05)。结论咽异物感伴反流症状的患者,通过反流治疗是有效的。对于有咽异物感的患者,经过长期治疗效果不明显,应考虑是否有咽喉反流的可能。

Objective To observe the clinical efficacy of anti-refleux therapy in patients w ith pharyngealforeign body sensation complicated w ith laryngopharyngeal reflux. Methods A total of 104 patients w ere selected as study subjects,w ho had self-rating foreign-body sensation score 3 points,disease course≥1 months,and received continuous anti-reflux treatment for more than 8 w eeks due to reflux symptom index（ RSI） 13 points and reflux clinical presentation syndrome（ RFS） 7 points after scoring. The rates of all reflux syndromes and signs of reflux clinical symptoms w ere analyzed,and clinical efficacy w as evaluated. Results Of the 104 patients,most had reflux symptom haw king behavior（ 92 /104,88. 46%）,w ith primary reflux signs being posterior commissurehypertrophy（ 97 /104,93. 27%）,Erythema / congestion（ 89 /104,85. 57%）,intra-throat sticky secretions（ 87 /104,83. 65%）,ventriculuslaryngis obstruction（ 73 /104,70. 19%） and so on. After anti-reflux treatment,61 were effective,with effective rate of 58. 65%. Compared w ith treatment before,there w as significant difference in RSI（ t = 1. 975,P〈0. 05） but no significant difference w as observed in RFS（ t = 1. 258,P〉0. 05） after treatment. Conclusion Anti-reflux treatment is effective to patients w ith pharyngealforeign body sensation complicated w ith laryngopharyngeal reflux. As to patients w ith pharyngealforeign body sensation,laryngopharyngeal reflux should be considered if long-term treatment show s no significant efficacy.