Thoman David S, Hui Thomas T, Spyrou Maria, Phillips Edward H
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
J Gastrointest Surg. 2002 Jan-Feb;6(1):17-21. doi: 10.1016/s1091-255x(01)00013-0.
In addition to heartburn and regurgitation, cough is a frequent nonspecific complaint of patients with gastroesophageal reflux disease. The incidence of alternative etiologies for patients with chronic cough who are undergoing antireflux surgery is not known. To determine this, and the response of chronic cough to fundoplication, we performed a retrospective review of 129 patients with proven gastroesophageal reflux referred for surgical therapy. Chronic cough was present in 37 (29%) preoperatively. No differences were found in age, sex, or preoperative manometric findings between those with and without chronic cough. Patients with cough had a higher number of lower esophageal reflux events on preoperative 24-hour pH testing, and were more likely to have persistent dysphagia after surgery. Fifty-nine percent of patients with cough had an alternative etiology for cough, compared to 36% of those without cough. Of the common alternative etiologies, only a history of postnasal drip occurred more frequently in those with cough. Complete resolution of cough occurred in 24 patients (64%), with another 10 (27%) reporting significant improvement. The average cough score improved significantly regardless of which coexisting etiology the patients may have had. Additionally, heartburn and regurgitation were improved in 94% of all patients.
除烧心和反流外，咳嗽是胃食管反流病患者常见的非特异性主诉。接受抗反流手术的慢性咳嗽患者中其他病因的发生率尚不清楚。为了确定这一点以及慢性咳嗽对胃底折叠术的反应，我们对129例经证实为胃食管反流并接受手术治疗的患者进行了回顾性研究。术前37例（29%）存在慢性咳嗽。有慢性咳嗽和无慢性咳嗽的患者在年龄、性别或术前测压结果方面未发现差异。咳嗽患者术前24小时pH值测试时食管下段反流事件更多，术后更易出现持续性吞咽困难。咳嗽患者中有59%存在咳嗽的其他病因，而无咳嗽患者中这一比例为36%。在常见的其他病因中，只有鼻后滴漏史在咳嗽患者中更常见。24例患者（64%）咳嗽完全缓解，另外10例（27%）报告有显著改善。无论患者可能存在何种并存病因，平均咳嗽评分均有显著改善。此外，所有患者中有94%的烧心和反流症状得到改善。
