喉咽反流病的管理综述。

Review of management of laryngopharyngeal reflux disease.

机构信息

Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Lille, Hôpital Claude Huriez, Lille, France.

Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Lille, Hôpital Claude Huriez, Lille, France.

出版信息

Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Sep;138(4):257-267. doi: 10.1016/j.anorl.2020.11.002. Epub 2020 Nov 27.

DOI:10.1016/j.anorl.2020.11.002

PMID:33257265

Abstract

This review was conducted according to the Patient/problem Intervention Comparison Outcome (PICO) Statements. Some studies reported that 10-30% of patients consulting in ENT come with presenting symptoms of laryngopharyngeal reflux (LPR), but the exact prevalence of LPR is still unknown. Management has not changed in 20 years despite a significant increase in the number of publications on epidemiology, clinical presentation, diagnosis and treatment. The development of hypopharyngeal-esophageal multichannel intraluminal impedance pH monitoring (HEMII-pH) and saliva pepsin detection now allow a new multidimensional diagnostic approach associating clinical scores to HEMII-pH and saliva pepsin detection. This new approach may enable personalized treatment according to LPR profile on HEMII-pH (acid, non-acid, mixed; upright, recumbent reflux episodes). Updated treatment of LPR could consist in a 3-month association of dietary measures, proton pump inhibitors, alginate and magaldrate, followed by treatment adaptation.

摘要

本综述是根据患者/问题干预比较结果（PICO）陈述进行的。一些研究报告称，耳鼻喉科就诊患者中有 10-30%存在咽喉反流（LPR）的表现症状，但 LPR 的确切患病率仍不清楚。尽管有关流行病学、临床表现、诊断和治疗的出版物数量显著增加，但 20 年来管理方法并未改变。咽食管多通道腔内阻抗 pH 监测（HEMII-pH）和唾液胃蛋白酶检测的发展现在允许采用一种新的多维诊断方法，将临床评分与 HEMII-pH 和唾液胃蛋白酶检测相结合。这种新方法可以根据 HEMII-pH（酸、非酸、混合；直立、仰卧反流发作）的 LPR 特征实现个体化治疗。LPR 的更新治疗可能包括 3 个月的饮食措施、质子泵抑制剂、藻酸盐和碳酸镁联合治疗，然后根据需要进行治疗调整。