摘要
目的探讨咽喉反流和胃食管反流与声带息肉发病的关系。方法2011年10月至2012年5月期间就诊于南方医院的声带息肉患者32例，采用36通道ManoScan360^TM 固态高分辨率食管测压系统（high—resolutionesophagealmanometry）和Zephr多通道腔内阻抗-pH监测（muhichannelintralumminalimpedancecombinedwithpH—metry，MII—pH）便携系统进行监测，观察食管上、下括约肌压力、食管动力分段特点及咽喉反流、胃食管反流事件及反流物性质，并与16例健康成人对照组比较。结果声带息肉组较对照组平均食管上括约肌松弛持续时间、松弛恢复时间、食管下括约肌长度均缩短，食团内压最大平均值增加，差异均有统计学意义（t值分别为2．244、2．624、2．310和-2．397，P值均〈0．05）。声带息肉组咽喉反流发生率为40．6％（13／32），胃食管反流发生率为50．0％（16／32）。声带息肉组与对照组咽喉酸反流次数中位数（肘[P25；P75]）分别为0．5[0．0；3．5]和0．0[0．0；0．0]次，酸反流时间分别为0．1[0．0；1．7]和0．0[0．0；0．0]min，酸清除时间分别为3．5[0．0；53．5]和0．0[0．0；0．0]S，DeMeester评分分别为14．8[1．6；31．3]和1．8[1．1；4．1]分，总计液体反流次数分别为46．5[25．3；69．0]和32．5[20．0；36．3]次。声带息肉组咽喉酸反流次数、酸反流时间、酸清除时间、DeMeester评分及总液体反流次数均较对照组增加，差异均有统计学意义（z值分别为2．481、2．767、2．767，2．344及1．980，P值均〈0．05）。结论声带息肉部分患者存在食管上、下括约结构与功能障碍，存在咽喉反流和胃食管反流，反流事件以立位酸反流为主。
Objective Through monitoring esophageal dynamic change, and detection of laryngopharyngeal reflux（LPR） and gastroesophageal reflux events,to discuss the relationship of vocal cord polyps with laryngopharyngeal reflux. Methods Thirty-two patients with vocal cord polyps were diagnosed by electronic laryngoscopy in Nanfang Hospital between October 2011 to May 2012. 3＂his study applied high- resolution esophageal manometry （HRM） and ambulatory 24-hour multichannel intraluminal impedance-pH monitoring（ MII-pH ）to obtain the upper esophageal sphincter （UES） and lower esophageal sphincter pressure, characteristics of sectional esophageal motility ; laryngopharyngeal reflux （ LPR ） and gastroesophageal reflux events, as well as the reflux properties of substances. Sixteen healthy volunteers were recruited as normal controls. Results UES relaxation duration, duration of UES relaxation time, UES relaxation recovery time and mean length of LES were all shorter than those of the control group （ t were 2. 244, 2. 624, 2.310 and -2.397, P〈0.05）. There were 40. 6% （13/32） LPR and 50. 0% （16/32） gastroesophageal reflux found in vocal polyp patients. Median number （M[ P25 ; P75 ] ） of laryngopharyngeal acid reflux events were 0. 5[0. 0;3.5] and 0. 0[0. 0;0. 0] in vocal polyp group and the controls, median mean time of laryngopharyngeal acid exposure 0. 1 [ 0. 0 ; 1.7 ] and 0. 0 [ 0. 0 ; 0. 0 ]min, median clearance time of laryngopharyngeal acid were 3.5 [ 0. 0 ; 53.5] and 0. 0 [ 0. 0 ; 0. 0 ] s, median scores of DeMeester were 14. 8[ 1.6;31.3] and 1.8[ 1.1 ;4. 1] and median frequency of total liquid reflux episodes were 46. 5[25.3 ;69. 0] and 32. 5 [ 20. 0;36. 3 ], respectively. The median numbers of laryngopharyngeal acid reflux events, time of acid exposure, time of acid clearance, DeMeester scores and frequency of total liquid reflux episodes were increased or higher in vocal polyp group than those in the controls （z were 2. 481, 2. 767, 2. 767, 2. 344 and 1. 980, P 〈 0.05 ）. Concl
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2013年第6期455-460,共6页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
声带
息肉
咽喉反流
胃食管反流
Vocal cords
Polyps
Laryngopharyngeal reflux
Gastroesophageal reflux
