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喉咽反流的病理生理学、临床表现及管理:一篇叙述性综述

Laryngopharyngeal Reflux Pathophysiology, Clinical Presentation, and Management: A Narrative Review.

作者信息

Barham William T, Alvarez-Amado Alana V, Dillman Kathryn M, Thibodeaux Elise, Nguyen Ivan D, Varrassi Giustino, Armstrong Catherine J, Howard Jeffrey, Ahmadzadeh Shahab, Mosieri Chizoba N, Kaye Adam M, Shekoohi Sahar, Kaye Alan D

机构信息

School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.

School of Medicine, American University of the Caribbean, Cupecoy, SXM.

出版信息

Cureus. 2024 Aug 20;16(8):e67305. doi: 10.7759/cureus.67305. eCollection 2024 Aug.

Abstract

Laryngopharyngeal reflux (LPR) is a common and often misinterpreted clinical entity responsible for various symptoms affecting the upper aerodigestive tract. This narrative literature review aims to review the pathophysiology, symptoms, and management of LPR, emphasizing the emerging understanding of gastric content reflux in aerodigestive tissue irritation. Understanding the pathophysiology of LPR will allow general practitioners and specialists to accurately recognize and treat a condition that causes substantial morbidity in the affected patients. Using evidence-based findings from randomized controlled trials, clinical studies, and meta-analyses, the present investigation aims to outline and unify previous research into LPR. A review of anatomical structures, pathogenic mechanisms, endoscopic findings in LPR, and clinical manifestations and treatment options are also discussed. Though controversy around the diagnosis and management of LPR persists, emerging research in cellular damage and diagnostic tools promises to provide increasingly accurate and reliable modalities for characterizing LPR. Hopefully, future research will unify the field and provide overarching guidelines for both primary care and specialists. The present investigation provides an integrated perspective on LPR, a clinically prevalent and complex disease.

摘要

喉咽反流(LPR)是一种常见且常被误解的临床病症,可导致影响上消化道和呼吸道的各种症状。本叙述性文献综述旨在回顾LPR的病理生理学、症状及管理,着重阐述对胃内容物反流引起上消化道和呼吸道组织刺激的新认识。了解LPR的病理生理学将使全科医生和专科医生能够准确识别和治疗这种给受影响患者带来严重发病风险的病症。本研究利用随机对照试验、临床研究和荟萃分析的循证结果,旨在梳理并整合此前关于LPR的研究。文中还讨论了LPR的解剖结构、致病机制、内镜检查结果、临床表现及治疗选择。尽管围绕LPR的诊断和管理仍存在争议,但细胞损伤和诊断工具方面的新研究有望为LPR的特征描述提供越来越准确可靠的方法。希望未来的研究能统一该领域,并为初级保健和专科医生提供总体指导方针。本研究提供了对LPR这一临床常见且复杂疾病的综合观点。

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