扬州地区咽喉反流性疾病的临床分析

Clinical surrey on LPRD in Yangzhou distriot

目的通过问卷调查研究扬州地区耳鼻咽喉头颈外科门诊患者中,咽喉反流性疾病(LPRD)患者在全部就诊患者中的比例,根据比例有针对性地开展与咽喉反流相关疾病的深入机制探讨,从而为该类疾病诊断和治疗提供国内的流行病学依据。方法本研究采取系统抽样的方法,从2017年7月1日~2018年6月30日,在苏北人民医院耳鼻咽喉头颈外科门诊患者中,抽取每月的第二周中周一至周五就诊序号尾号为5的患者,用反流症状指数量表(RSI)对患者进行调查。填写完成后对患者所填量表数据进行记录和汇总。阳性:RSI评分>13分,拟诊为LPRD;阴性:RSI评分≤13分。统计方法采用计数资料卡方检验,并根据数据进行连续性矫正。检验标准P<0.05认为差异有统计学意义。结果共收集了1598例患者的数据,年龄段为18~90岁,其中RSI评分>13分即阳性患者有39例。通过卡方检验,发现青年患者(18~40岁)RSI评分阳性率高于中年患者(41~65岁),差异有统计学意义(P=0.0341)。RSI评分阳性患者中男女比例21:18,在各年龄段中分别比较均无明显差异(P>0.05)。RSI阳性患者中4例服用过抑制胃酸或胃动力药,7例既往有吸烟史,6例既往有饮酒史。临床症状方面,RSI阳性患者中表现出咽部异物感的有37例、持续清嗓的有33例、痰过多或鼻涕倒流的有32例、烦人的咳嗽有32例、饭后或躺下后咳嗽有30例、声嘶或发音障碍有25例、呼吸不畅或反复窒息发作有23例、烧心胸痛胃痛有22例、吞咽食物或水或药片不利有19例。结论扬州地区咽喉反流性疾病的发病率约为2.44%,青年患者发病率高于中年患者。LPRD发病率与性别、吸烟、饮酒史无明显关联,临床症状主要表现为咽部异物感、持续清嗓、痰过多或鼻涕倒流、烦人的咳嗽、饭后或躺下后咳嗽等。临床上对LPRD漏诊率较高,大多患者没有接受到正确的药物治疗。

Objective To investigate the proportion of patients with Laryngopharyngeal Reflux Disease(LPRD)in all outpatients in the department of Otolaryngology Head and Neck Surgery in Yangzhou,and to explore the in-depth mechanism of diseases related to throat reflux according to the proportion.The survey can provide a domestic epidemiological basis for the diagnosis and treatment of LPRD.Methods By using the systematic sampling method,some patients were taken from a certain proportion of the outpatients of Otolaryngology Head and Neck Surgery department of Northern Jiangsu People’s Hospital in 2017.7-2018.6.The patients who had a last number of 5 were investigated with the reflux symptom scale(RSI).Positive:RSI score>13;negative:RSI score≤13.Statistical analysis was performed with the chi-square test.P value of less than 0.05 by the test was considered a statistically significant difference.Results A total of 1598 patients were collected.There are 39 patients whose RSI scores are more than 13 with a male to female ratio of 21:18.The young patients have a higher incidence of LPRD than the middle-aged patients.Among them,4 patients have used proton pump inhibitors or gastric motility drug;7 patients had a smoking history and 6 patients had a alcohol drinking history.In terms of clinical manifestations,among the 39 patients,the number of the patients suffering foreign body sensation,constant clearing of the throat,abundance of phlegm,annoying coughs,coughing after meal,hoarseness,difficult breathing,chest pain and difficult swallowing are 37,33,32,32,30,25,23,22 and 19 respectively.Conclusions The incidence of LPRD in Yangzhou is about 2.44%,which was not significantly related to gender,smoking,and drinking history.The young patients have a higher incidence of LPRD than the middle-aged patients.The main symptoms are foreign body sensation,constant clearing of the throat,abundance of phlegm,annoying coughs and coughing after meal.The rate of misdiagnosis is high and most patients didn’t receive the correct medicine.