抑酸剂对声带白斑术后临床症状及生活质量的影响

The effect of gastric acid inhibitor on postoperative clinical symptoms and quality of life in patients with vocal cord leukoplakia

目的观察抑酸剂对声带白斑术后临床症状及生活质量的影响,探讨其对治疗声带白斑的作用。方法选取2015年12月—2018年12月北京大学深圳医院耳鼻喉科收治的声带白斑并伴有咽喉反流的患者50例,根据随机数字表将患者随机分为研究组(口服抑酸剂艾司奥美拉唑治疗)和对照组(未口服抑酸剂艾司奥美拉唑治疗),每组25例。手术治疗8周后观察各患者的复发及癌变情况、反流症状指数量表(RSI)、体征指数量表(RFS)、嗓音障碍指数-10量表(VHI-10)、嗓音功能(振幅微扰、噪/谐比、基频微扰)、电子喉镜检查(声带振动对称性、声带黏膜波)、生活治疗量表(SF-36)评分等。结果研究组治疗前后RSI、RFS的差值大于对照组(P<0.05),研究组治疗前后基频微扰、振幅微扰、噪/谐比及声带黏膜波的差值大于对照组(P<0.05),研究组治疗前后一般健康状况、生理功能、躯体疼痛、精力、社会功能、精神健康评分的差值小于对照组(P<0.05)。结论抑酸剂能够减轻伴有咽喉反流的声带白斑术后患者的反流症状,改善患者嗓音功能、声带功能,提高其生活质量。

Objective To observe the effect of gastric acid inhibitor on postoperative clinical symptoms and quality of life of patients with vocal cord leukoplakia,and to explore the important role of gastric acid inhibitors in the treatment of vocal cord leukoplakia.Methods Fifty patients with vocal cord leukoplakia accompanied by laryngopharyngeal reflux admitted to the Department of Otolaryngology of Peking University Shenzhen Hospital from December 2015 to December 2018 were enrolled.According to the random number table,50 patients were randomly divided into study group(with esomeprazole treatment)and control group(without esomeprazole treatment)with 25 cases in each group.Eight weeks after surgery,the recurrence and cancerization,scores of Reflux Symptom Index(RSI),Reflux Finding Score(RFS),Voice Handicap Index-10(VHI-10)and 36-Item Short Form Health Survey(SF-36),voice function(amplitude perturbation,noise to harmonic ratio,fundamental frequency perturbation),and electronic laryngoscopy(the symmetry of vocal cord vibration and mucosal wave)were observed.Results There was no significant difference in recurrence rate and cancerization rate between the two groups after treatment(P>0.05).The differences in scores of RSI and RFS before and after the treatment were higher in the study group than those in the control group(P<0.05).Compared with the control group,the differences in fundamental frequency perturbation,amplitude perturbation,noise to harmonic ratio and mucosal wave before and after the treatment were greater in the study group(P<0.05).Besides,the differences in scores of general health,physical functioning,bodily pain,vitality,social functioning and mental health before and after the treatment were lower in the study group that those in the control group(P<0.05).Conclusions The gastric acid inhibitor esomeprazole can relieve the reflux symptoms of patients with vocal cord leukoplakia accompanied by laryngopharyngeal reflux,improve their voice function and vocal cord function,and enhance their quality of life.