抑酸治疗对声带白斑术后相关症状的影响

发布时间：2018-08-03 11:36

【摘要】：目的临床上对于抑酸治疗控制声带白斑的必要性还存在争议。文中旨在通过观察咽喉反流对声带白斑术后相关症状的影响,探讨咽喉反流在声带白斑进展中的作用,明确抑酸治疗在声带白斑治疗中的重要性。方法选取2013年6月至2015年12月在南京军区南京总医院耳鼻咽喉头颈外科行声带白斑手术切除的患者97例。根据24 h测酸结果将声带白斑患者分为反流组(n=26,咽喉反流)与非反流组(n=71,咽喉未反流)。并采用随机数字表法将反流组患者随机分为抑酸治疗组(n=13,口服埃索美拉唑)和非抑酸治疗组(n=13,口服安慰剂)。所有患者于术前和术后8周记录电子喉镜、嗓音障碍指数-10量表(VHI-10)、反流性喉炎症状指数量表(RSI)以及体征指数量表(RFS)结果并进行比较,观察咽喉反流及抑酸治疗对声带白斑术后症状的影响。结果反流组术后8周RSI、RFS较术前明显降低[(13.6±5.8)分vs(18.2±6.2)分,(9.2±2.4)分vs(10.6±2.8)分,P0.05]。反流组手术前后RSI、RFS差值较非反流组增大[(5.8±1.4)分vs(2.3±0.8)分,(1.2±0.6)分vs(0.5±0.2)分,P0.05]。抑酸治疗组手术前后RSI、RFS差值较非抑酸治疗组增大[(6.6±1.2)分vs(0.8±0.6)分;(2.6±0.6)分vs(0.5±0.3)分,P0.05]。抑酸治疗组术后8周VHI-10较术前明显降低[(12.6±3.6)分vs(15.2±4.2)分,P0.05]。结论伴有咽喉反流的声带白斑患者给予正规的质子泵抑制剂治疗,可以减轻咽喉反流的症状,并有效地改善声音嘶哑。
[Abstract]:Objective to discuss the necessity of acid suppression therapy for vocal cord leukoplakia control. The purpose of this paper is to investigate the effect of laryngeal reflux on the related symptoms after vocal cord leukoplakia, to explore the role of throat reflux in the progression of vocal cord leukoplakia, and to clarify the importance of acid suppression in the treatment of vocal cord leukoplakia. Methods 97 patients with vocal cord leukoplakia were selected from June 2013 to December 2015 in the Department of Otolaryngology and head and neck surgery of Nanjing General Hospital of Nanjing military region. Patients with vocal cord leukoplakia were divided into reflux group (n = 26) and non-reflux group (n ~ (71). The patients in the reflux group were randomly divided into two groups: the control group (n = 13) and the control group (n ~ (13) with oral esomeprazole (n ~ (13) or placebo (n ~ (13). The results of electronic laryngoscope, voice disturbance index -10 (VHI-10), reflux laryngitis symptom index (RSI) and physical sign index (RFS) were recorded and compared between all patients before and 8 weeks after operation. To observe the effect of throat reflux and acid suppression on postoperative symptoms of vocal cord leukoplakia. Results in the reflux group, the RSIV RFS decreased significantly 8 weeks after operation [(13.6 卤5.8) vs (18.2 卤6.2), (9.2 卤2.4) vs (10.6 卤2.8), P0.05]. The RSI RFS difference before and after operation in the reflux group was significantly higher than that in the non-reflux group [(5.8 卤1.4) vs (2.3 卤0.8), (1.2 卤0.6) vs (0.5 卤0.2) (P0.05)]. The difference of RSIN RFS before and after operation in the acid-suppressive group was significantly higher than that in the non-acid-suppressive group [(6.6 卤1.2) vs (0.8 卤0.6); (2.6 卤0.6) vs (0.5 卤0.3), P0.05]. The VHI-10 in the acid-suppressive treatment group was significantly lower than that before operation at 8 weeks after operation [(12.6 卤3.6) vs (15.2 卤4.2) (P0.05)]. Conclusion the patients with vocal cord leukoplakia with throat reflux can be treated with proton pump inhibitor, which can alleviate the symptoms of throat reflux and effectively improve the hoarseness of voice.
【作者单位】：第二军医大学长海医院耳鼻咽喉科;南京军区南京总医院耳鼻咽喉头颈外科;
【基金】：江苏省自然科学基金(BK20161388)
【分类号】：R767.91

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