咽喉反流对男性声带突肉芽肿患者治疗效果的影响

Effect of laryngopharyngeal reflux on the therapeutic for vocal process granuloma

目的探讨咽喉反流对男性特发性喉接触性肉芽肿治疗效果的影响。方法以2016年6月至2018年2月确诊为特发性声带突肉芽肿的109例男性患者为研究对象,均填写咽喉反流症状指数评分量表(RSI)和反流体征评分量表(RFS),RSI>13或/和RFS>7的患者判断为有咽喉反流,其中,69例有咽喉反流,40例无咽喉反流,对所有患者给予口服奥美拉唑和经甲舌膜声带注射曲安奈德治疗,比较有、无咽喉反流者的治愈率及平均治愈时间。结果 109例患者中共治愈87例,有咽喉反流者治愈率(72.46%,50/69)低于无咽喉反流者(92.5%,37/40)(P=0.013);治愈患者中有咽喉反流者的平均治愈时间(5.04±1.66月)长于无咽喉反流者(3.48±1.73月)(Z=-3.876,P<0.001)。结论抑酸加糖皮质激素局部应用可有效治疗声带突肉芽肿;男性咽喉反流特发性声带突肉芽肿患者治疗效果较差。

Objective To investigate the laryngopharyngeal reflux on the therapeutic effect of male idiopathic Vocal process granuloma.Methods The clinical data of 109 male patients with idiopathic vocal process granuloma from June 2016 to February 2018 were analyzed retrospectively.All patients were treated with glucocorticoid injection through thyroglossal combined with oral PPI.Using RSI>13 or RFS>7 as the criterion for the existence of laryngopharyngeal reflux,we judged there were 69 cases of laryngopharyngeal reflux and 40 cases of non-laryngopharyngeal reflux.We reflected the effect of laryngopharyngeal reflux on the therapeutic effect by comparing the difference of cure rate between patients with laryngopharyngeal reflux and patients with non-laryngopharyngeal reflux and the difference in cure time between patients with and without laryngopharyngeal reflux.Results Among the 109 male patients,87 cases were cured and 22 cases were uncured.Among them,the cure rate of patients with non-laryngopharyngeal reflux was 72.46%(50/69),and the cure rate without laryngopharyngeal reflux was 92.50%(37/40).The cure rate of patients with laryngopharyngeal reflux was lower than that of patients without laryngopharyngeal reflux(P=0.013);There was difference in cure time between the laryngopharyngeal reflux and the non-laryngopharyngeal reflux in the cured patients(Z=-3.876;P=0.000).The average cure time was(5.04±1.66)months in the patients with laryngopharyngeal reflux,which was longer than of non-laryngopharyngeal reflux(3.48±1.73)months.Conclusion Male patients_idiopathic vocal process granuloma with laryngopharyngeal reflux are less effective.