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[喉咽反流]

[Laryngopharyngeal Reflux].

作者信息

Reiter Rudolf, Heyduck Adrienne, Seufferlein Thomas, Hoffmann Thomas, Pickhard Anja

机构信息

Univ.-Klinik Ulm Sektion Phoniatrie und Pädaudiologie der Universitätsklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie.

Universitätsklinik Ulm, Universitätsklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie.

出版信息

Laryngorhinootologie. 2018 Apr;97(4):238-245. doi: 10.1055/s-0044-100794. Epub 2018 Apr 10.

Abstract

The prevalence of laryngopharyngeal reflux (LPR) is around 31 % in the general population. Patients with a dysphonia or other laryngeal diseases are accompanied up to 50 % by an LPR. Typical reflux associated diseases of the larynx are a chronical laryngitis and a contact granuloma. The role of LPR is still not clarified in the development of a glottic carcinoma. There still doesn't exist evidence based data for the diagnosis of a LPR. Therefore LPR is usually clinically diagnosed by a combination of typical symptoms like hoarseness, chronic coughing, relapsing throat clearing, globus pharyngis and dysphagia as well as through the laryngoscopic characteristics like mucosal erythema, mucosal hyperplasia with plication of the interarytenoid region and an edema of the vocal cords. Occasionally the LPR can be ensured with the additional method of the pharyngeal 24-hour pH-monitoring. The therapy of the LPR is a multimodal for example dietary arrangements, medication with proton pump inhibitors and where indicated a surgical intervention. The treatment of a symptomatic patient is administered by proton pump inhibitors in a close dialog with the ENT practitioner and the gastroenterologist.

摘要

喉咽反流(LPR)在普通人群中的患病率约为31%。患有发音障碍或其他喉部疾病的患者中,LPR的伴随率高达50%。典型的与反流相关的喉部疾病是慢性喉炎和接触性肉芽肿。LPR在声门癌发生发展中的作用仍未明确。目前仍不存在基于证据的数据用于LPR的诊断。因此,LPR通常通过诸如声音嘶哑、慢性咳嗽、反复清嗓、咽部异物感和吞咽困难等典型症状,以及喉镜特征如黏膜红斑、杓间区黏膜增生伴襞形成和声带水肿等进行临床诊断。偶尔,可通过额外的24小时咽pH监测方法来确诊LPR。LPR的治疗是多模式的,例如饮食安排、使用质子泵抑制剂药物以及在必要时进行手术干预。有症状患者的治疗由质子泵抑制剂进行,并与耳鼻喉科医生和胃肠病学家密切沟通。

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