BACKGROUND Most endoscopic anti-reflux interventions for gastroesophageal reflux disease(GERD)management are technically challenging to practice with inadequate data to support it utility.Therefore,this study was carr...BACKGROUND Most endoscopic anti-reflux interventions for gastroesophageal reflux disease(GERD)management are technically challenging to practice with inadequate data to support it utility.Therefore,this study was carried to evaluate the effectiveness and safety newer endoscopic full-thickness fundoplication(EFTP)device along with Argon Plasma Coagulation to treat individuals with GERD.AIM To evaluate the effectiveness and safety newer EFTP device along with Argon Plasma Coagulation to treat individuals with GERD.METHODS This study was a single-center comparative analysis conducted on patients treated at a Noble Institute of Gastroenterology,Ahmedabad,hospital between 2020 and 2022.The research aimed to retrospectively analyze patient data on GERD symptoms and proton pump inhibitor(PPI)dependence who underwent EFTP using the GERD-X system along with argon plasma coagulation(APC).The primary endpoint was the mean change in the total gastroesophageal reflux disease health-related quality of life(GERD-HRQL)score compared to the baseline measurement at the 3-month follow-up.Secondary endpoints encompassed enhancements in the overall GERD-HRQL score,improvements in GERD symptom scores at the 3 and changes in PPI usage at the 3 and 12-month time points.RESULTS In this study,patients most were in Hill Class II,and over half had ineffective esophageal motility.Following the EFTP procedure,there were significant improvements in heartburn and regurgitation scores,as well as GERDHRQL scores(P<0.001).PPI use significantly decreased,with 82.6%not needing PPIs or prokinetics at end of 1 year.No significant adverse events related to the procedures were observed in either group.CONCLUSION The EFTP along with APC procedure shows promise in addressing GERD symptoms and improving patients'quality of life,particularly for suitable candidates.Moreover,the application of a lone clip with APC yielded superior outcomes and exhibited greater cost-effectiveness.展开更多
AIM： To suspect laryngopharyngeal reflux（LPR） in patients with ocular surface disease（OSD）. METHODS： The present study evaluated a group of subjects with OSD assessing the Ocular Surface Disease Index（OSDI） an...AIM： To suspect laryngopharyngeal reflux（LPR） in patients with ocular surface disease（OSD）. METHODS： The present study evaluated a group of subjects with OSD assessing the Ocular Surface Disease Index（OSDI） and the Reflux Symptom Index（RSI） to detect patients with suspected LPR and define a possible relationship between tests.RESULTS： Two hundred and ninety subjects（175 females, mean age： 60.41±15.68y） were consecutively visited at ophthalmologist offices. One hundred and one（34%） patients had pathological RSI（〉13） and consequently a suspected LPR.CONCLUSION： The current study shows that suspected LPR may be common（34%） in patients with OSD and a suspected LPR may be considered in OSD patients when RSI score is 〉13 and OSDI score is 〉42.展开更多
Background: Gastroesophageal reflux disease (GERD) is a disorder resulting from the reversed flow of gastroduodenal contents into the esophagus, and producing different symptoms, while laryngopharyngeal reflux (LPR) i...Background: Gastroesophageal reflux disease (GERD) is a disorder resulting from the reversed flow of gastroduodenal contents into the esophagus, and producing different symptoms, while laryngopharyngeal reflux (LPR) is a disorder resulting from the reversed flow of gastric contents into the hypopharynx. The aim of this work is to evaluate LPR in cases of GERD. Methods: The present study was performed on fifty GERD patients diagnosed by gastroscope. LPR was assessed by reflux symptoms score (RSI) and reflux finding score (RFS). Accordingly, patients are classified into: Group I = 25 patients with manifest LPR, and Group II = 25 control patients without LPR symptoms. Results: GERD accounts for 17.4% of attendants of gastroscope unit, where manifest LPR accounts for 29.1% of GERD cases recording mean RSI and RFS 16.48 and 8.44 respectively. Silent LPR accounts for 8% recording mean RFS 7. Conclusion: There is a significant direct proportional relationship between severity of GERD and the RSI and RFS (p = 0.015 and 0.005 respectively).展开更多
目的探讨口腔唾液胃蛋白酶检测对咽喉反流患者的诊断价值。方法选取2017年1月至2018年10月陕西省人民医院收治的118例咽喉反流患者为研究对象,其中单纯咽喉炎94例,咽喉占位性病变24例,使用24 h双探头试管pH值监测法、酶联免疫吸附法对...目的探讨口腔唾液胃蛋白酶检测对咽喉反流患者的诊断价值。方法选取2017年1月至2018年10月陕西省人民医院收治的118例咽喉反流患者为研究对象,其中单纯咽喉炎94例,咽喉占位性病变24例,使用24 h双探头试管pH值监测法、酶联免疫吸附法对患者进行检查诊断,记录患者反流症状指数评分表和反流体征指数评分表诊断结果,并采用Kappa检验两种诊断方法一致性,ROC曲线检测口腔唾液胃蛋白酶检测法和24 h双探头试管pH值监测法对咽喉反流的诊断价值。结果反流症状指数评分表和反流体征指数评分表评估的阳性率为56.78%,其中反流症状指数评分表评估阳性率为47.46%,反流体征指数评分表评估阳性率为9.32%;单纯咽喉炎患者Ryan指数阳性率为5.32%,咽喉占位性病变患者Ryan指数阳性率为29.17%,差异有显著统计学意义(P<0.01);单纯咽喉炎患者存在1次及以上pH<6.0反流情况阳性率为50.00%,明显低于咽喉占位性病变患者的70.83%,差异有统计学意义(P<0.05);患者症状发作15 min唾液胃蛋白酶阳性率为44.07%,明显高于其余时间段(晨起7.63%,餐后1 h 3.39%,睡前4.24%),差异均有统计学意义(P<0.05);单纯咽喉炎患者唾液胃蛋白酶阳性率为53.19%,明显低于咽喉占位性病变患者的83.33%,差异有统计学意义(P<0.05);构建两种检测方法ROC曲线,发现口腔唾液胃蛋白酶检测法诊断咽喉反流ROC曲线下面积分别为症状明显时0.874(0.722,1.000),餐后1 h 0.825(0.669,0.979),晨起0.760(0.601,0.918),大于24 h双探头试管pH值监测法[症状明显时0.736(0.718,1.000),餐后1 h 0.737(0.651,0.935),晨起0.682(0.593,0.829)],差异均有统计学意义(P<0.05)。结论口腔唾液胃蛋白酶检测法较之咽部pH检测法能更好检测诊断咽喉反流疾病,可推广应用。展开更多
目的探讨口腔矫正器佩戴在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并咽喉反流(LPR)患者中的临床应用效果。方法选取2016年8月—2018年1月在广州医科大学附属第一医院耳鼻喉头颈外科确诊为OSAHS的46例患者采用6个月口腔矫正器进行干预...目的探讨口腔矫正器佩戴在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并咽喉反流(LPR)患者中的临床应用效果。方法选取2016年8月—2018年1月在广州医科大学附属第一医院耳鼻喉头颈外科确诊为OSAHS的46例患者采用6个月口腔矫正器进行干预,分别在干预前、干预6个月后进行多导睡眠监测仪和Dx-pH监测,并完成反流症状指数量表(RSI)和反流体征评分量表(RFS)。比较患者干预前后睡眠打鼾、睡眠呼吸暂停低通气指数(AHI)、24 h pH监测、LPR相关症状、RSI和RFS。结果干预前,RSI>13分和/或RFS>7分的患者共17例,干预6个月后仅3例;干预前,立位和/或卧位Ryan指数阳性的患者共11例;干预6个月后仅2例。患者AHI、鼾声指数、RSI、立位Ryan指数、卧位Ryan指数均较干预前显著降低,平均血氧饱和度显著升高,差异有高度统计学意义(P<0.01)。RSI多个分项(持续清嗓、痰过多或鼻涕倒流、呼吸不畅或反复窒息发作、咽喉异物感)以及RFS分项(喉内黏液附着、弥漫性喉水肿)评分较干预前显著降低,差异有高度统计学意义(P<0.01)。结论口腔矫正器有助于治疗OSAHS合并LPR患者,可明显缓解患者LPR症状。展开更多
文摘BACKGROUND Most endoscopic anti-reflux interventions for gastroesophageal reflux disease(GERD)management are technically challenging to practice with inadequate data to support it utility.Therefore,this study was carried to evaluate the effectiveness and safety newer endoscopic full-thickness fundoplication(EFTP)device along with Argon Plasma Coagulation to treat individuals with GERD.AIM To evaluate the effectiveness and safety newer EFTP device along with Argon Plasma Coagulation to treat individuals with GERD.METHODS This study was a single-center comparative analysis conducted on patients treated at a Noble Institute of Gastroenterology,Ahmedabad,hospital between 2020 and 2022.The research aimed to retrospectively analyze patient data on GERD symptoms and proton pump inhibitor(PPI)dependence who underwent EFTP using the GERD-X system along with argon plasma coagulation(APC).The primary endpoint was the mean change in the total gastroesophageal reflux disease health-related quality of life(GERD-HRQL)score compared to the baseline measurement at the 3-month follow-up.Secondary endpoints encompassed enhancements in the overall GERD-HRQL score,improvements in GERD symptom scores at the 3 and changes in PPI usage at the 3 and 12-month time points.RESULTS In this study,patients most were in Hill Class II,and over half had ineffective esophageal motility.Following the EFTP procedure,there were significant improvements in heartburn and regurgitation scores,as well as GERDHRQL scores(P<0.001).PPI use significantly decreased,with 82.6%not needing PPIs or prokinetics at end of 1 year.No significant adverse events related to the procedures were observed in either group.CONCLUSION The EFTP along with APC procedure shows promise in addressing GERD symptoms and improving patients'quality of life,particularly for suitable candidates.Moreover,the application of a lone clip with APC yielded superior outcomes and exhibited greater cost-effectiveness.
文摘AIM： To suspect laryngopharyngeal reflux（LPR） in patients with ocular surface disease（OSD）. METHODS： The present study evaluated a group of subjects with OSD assessing the Ocular Surface Disease Index（OSDI） and the Reflux Symptom Index（RSI） to detect patients with suspected LPR and define a possible relationship between tests.RESULTS： Two hundred and ninety subjects（175 females, mean age： 60.41±15.68y） were consecutively visited at ophthalmologist offices. One hundred and one（34%） patients had pathological RSI（〉13） and consequently a suspected LPR.CONCLUSION： The current study shows that suspected LPR may be common（34%） in patients with OSD and a suspected LPR may be considered in OSD patients when RSI score is 〉13 and OSDI score is 〉42.
文摘Background: Gastroesophageal reflux disease (GERD) is a disorder resulting from the reversed flow of gastroduodenal contents into the esophagus, and producing different symptoms, while laryngopharyngeal reflux (LPR) is a disorder resulting from the reversed flow of gastric contents into the hypopharynx. The aim of this work is to evaluate LPR in cases of GERD. Methods: The present study was performed on fifty GERD patients diagnosed by gastroscope. LPR was assessed by reflux symptoms score (RSI) and reflux finding score (RFS). Accordingly, patients are classified into: Group I = 25 patients with manifest LPR, and Group II = 25 control patients without LPR symptoms. Results: GERD accounts for 17.4% of attendants of gastroscope unit, where manifest LPR accounts for 29.1% of GERD cases recording mean RSI and RFS 16.48 and 8.44 respectively. Silent LPR accounts for 8% recording mean RFS 7. Conclusion: There is a significant direct proportional relationship between severity of GERD and the RSI and RFS (p = 0.015 and 0.005 respectively).
文摘目的探讨口腔唾液胃蛋白酶检测对咽喉反流患者的诊断价值。方法选取2017年1月至2018年10月陕西省人民医院收治的118例咽喉反流患者为研究对象,其中单纯咽喉炎94例,咽喉占位性病变24例,使用24 h双探头试管pH值监测法、酶联免疫吸附法对患者进行检查诊断,记录患者反流症状指数评分表和反流体征指数评分表诊断结果,并采用Kappa检验两种诊断方法一致性,ROC曲线检测口腔唾液胃蛋白酶检测法和24 h双探头试管pH值监测法对咽喉反流的诊断价值。结果反流症状指数评分表和反流体征指数评分表评估的阳性率为56.78%,其中反流症状指数评分表评估阳性率为47.46%,反流体征指数评分表评估阳性率为9.32%;单纯咽喉炎患者Ryan指数阳性率为5.32%,咽喉占位性病变患者Ryan指数阳性率为29.17%,差异有显著统计学意义(P<0.01);单纯咽喉炎患者存在1次及以上pH<6.0反流情况阳性率为50.00%,明显低于咽喉占位性病变患者的70.83%,差异有统计学意义(P<0.05);患者症状发作15 min唾液胃蛋白酶阳性率为44.07%,明显高于其余时间段(晨起7.63%,餐后1 h 3.39%,睡前4.24%),差异均有统计学意义(P<0.05);单纯咽喉炎患者唾液胃蛋白酶阳性率为53.19%,明显低于咽喉占位性病变患者的83.33%,差异有统计学意义(P<0.05);构建两种检测方法ROC曲线,发现口腔唾液胃蛋白酶检测法诊断咽喉反流ROC曲线下面积分别为症状明显时0.874(0.722,1.000),餐后1 h 0.825(0.669,0.979),晨起0.760(0.601,0.918),大于24 h双探头试管pH值监测法[症状明显时0.736(0.718,1.000),餐后1 h 0.737(0.651,0.935),晨起0.682(0.593,0.829)],差异均有统计学意义(P<0.05)。结论口腔唾液胃蛋白酶检测法较之咽部pH检测法能更好检测诊断咽喉反流疾病,可推广应用。
文摘目的探讨口腔矫正器佩戴在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并咽喉反流(LPR)患者中的临床应用效果。方法选取2016年8月—2018年1月在广州医科大学附属第一医院耳鼻喉头颈外科确诊为OSAHS的46例患者采用6个月口腔矫正器进行干预,分别在干预前、干预6个月后进行多导睡眠监测仪和Dx-pH监测,并完成反流症状指数量表(RSI)和反流体征评分量表(RFS)。比较患者干预前后睡眠打鼾、睡眠呼吸暂停低通气指数(AHI)、24 h pH监测、LPR相关症状、RSI和RFS。结果干预前,RSI>13分和/或RFS>7分的患者共17例,干预6个月后仅3例;干预前,立位和/或卧位Ryan指数阳性的患者共11例;干预6个月后仅2例。患者AHI、鼾声指数、RSI、立位Ryan指数、卧位Ryan指数均较干预前显著降低,平均血氧饱和度显著升高,差异有高度统计学意义(P<0.01)。RSI多个分项(持续清嗓、痰过多或鼻涕倒流、呼吸不畅或反复窒息发作、咽喉异物感)以及RFS分项(喉内黏液附着、弥漫性喉水肿)评分较干预前显著降低,差异有高度统计学意义(P<0.01)。结论口腔矫正器有助于治疗OSAHS合并LPR患者,可明显缓解患者LPR症状。
