Dx-pH监测系统在儿童咽喉反流诊断应用中的初步研究
发布时间：2018-10-10 15:07
【摘要】：目的探讨Dx-pH监测在咽喉反流(LPR)诊断中的应用价值,及其与质子泵抑制剂(PPI)诊断性试验结果的一致性,为儿童咽喉反流的诊断提供参考。方法选取2016年1月至2016年12月于深圳市儿童医院耳鼻喉科就诊的患儿。予反流症状指数评分量表(RSI)和反流体征评分量表(RFS)评分,将RSI13分和/或RFS7分的患儿纳入研究,排除不符合标准的病例后共59例入选。依据年龄分为学龄前组和学龄组。所有患儿行咽喉pH检测,予饮食管理+抗反流治疗,每例患儿至少随访3个月,观察患儿相应症状改善情况。期间失访6例,追踪到53例。结果53例符合研究标准患儿,其中男性39例,女性14例。学龄前组29例,学龄组24例。入选患儿多有合并症,以合并鼻窦炎、咽炎、腺样体肥大、喉炎及中耳炎常见。是否有合并疾病,对LPR的治疗效果无影响。(1),学龄前组和学龄组治疗前RFS评分,组间无统计学差异(P0.05),不同体征出现的频率差异无统计学意义,RSI评分差异无统计学意义(P0.05)。(2)以Ryan指数为诊断标准得出其中15例患者可确诊为LPR(28.3%)。pH事件≥3次有41例(77.4%),另有2例(3.8%)提示碱反流。(3)所有患者服用质子泵抑制剂(PPI)4周后,18例(34.0%)显效,24例(45.3%)好转,11例(20.8)无明显改善,整体有效率为79.3%。(4)PPI诊断性试验与Ryan指数结果一致性较差,和pH事件≥3次结果一致性中等。结论(1)Dx-pH监测系统能准确监测到反流事件,客观证实LPR的存在。(2)儿童LPR多合并其他疾病共同存在,在鼻窦炎、中耳炎反复发作治疗效果不佳时应考虑是否合并LPR。(3)儿童LPR多数体征表现较成人轻,饮食调整加规范抗反流治疗,多数可取得较好的治疗效果。(4)当依据患者症状和喉镜下体征疑诊LRP,而以Ryan指数为判定标准的24小时Dx-pH监测为阴性时,参考pH事件≥3次的反流数据可有助于对患者病情的综合判断。
[Abstract]:Objective to explore the value of Dx-pH monitoring in the diagnosis of laryngeal reflux (LPR) and its consistency with the diagnostic results of proton pump inhibitor (PPI) in order to provide a reference for the diagnosis of laryngeal reflux in children. Methods Children from January 2016 to December 2016 were selected from otolaryngology department of Shenzhen Children's Hospital. Reflux symptom index scale (RSI) and reflux sign scale (RFS) were given to children with RSI13 and / or RFS7 scores. 59 cases were included in the study after substandard cases were excluded. According to the age, it was divided into preschool group and school age group. All the children were examined with pharynx and throat pH and treated with diet management anti-reflux therapy. Each patient was followed up for at least 3 months to observe the improvement of the corresponding symptoms. 6 cases were lost during the visit, 53 cases were followed up. Results 53 cases, 39 males and 14 females, met the criteria of the study. 29 cases in preschool group and 24 cases in school age group. Most of the patients were complicated with sinusitis, pharyngitis, adenoid hypertrophy, laryngitis and otitis media. There was no effect on the therapeutic effect of LPR. (1) the pre-school group and preschool group had pre-treatment RFS score. There was no statistical difference between the two groups (P0.05), and there was no significant difference in frequency of different signs (P0.05). (2). According to Ryan index, 15 patients were diagnosed as LPR (28.3%). PH events 鈮，
本文编号：2262236
[Abstract]:Objective to explore the value of Dx-pH monitoring in the diagnosis of laryngeal reflux (LPR) and its consistency with the diagnostic results of proton pump inhibitor (PPI) in order to provide a reference for the diagnosis of laryngeal reflux in children. Methods Children from January 2016 to December 2016 were selected from otolaryngology department of Shenzhen Children's Hospital. Reflux symptom index scale (RSI) and reflux sign scale (RFS) were given to children with RSI13 and / or RFS7 scores. 59 cases were included in the study after substandard cases were excluded. According to the age, it was divided into preschool group and school age group. All the children were examined with pharynx and throat pH and treated with diet management anti-reflux therapy. Each patient was followed up for at least 3 months to observe the improvement of the corresponding symptoms. 6 cases were lost during the visit, 53 cases were followed up. Results 53 cases, 39 males and 14 females, met the criteria of the study. 29 cases in preschool group and 24 cases in school age group. Most of the patients were complicated with sinusitis, pharyngitis, adenoid hypertrophy, laryngitis and otitis media. There was no effect on the therapeutic effect of LPR. (1) the pre-school group and preschool group had pre-treatment RFS score. There was no statistical difference between the two groups (P0.05), and there was no significant difference in frequency of different signs (P0.05). (2). According to Ryan index, 15 patients were diagnosed as LPR (28.3%). PH events 鈮，
本文编号：2262236
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