학술논문
抑酸治疗对声带白斑术后相关症状的影响 / Effect in symptoms of acid suppression therapy on postoperative recurrence of vocal leukoplakia
Document Type
Academic Journal
Author
陈伟; 季寒; 吴明海; 潘晗; 王志颐; 许莉; 张勇; 郑宏良; CHEN Wei; JI Han; WU Ming-hai; PAN Han; WANG Zhi-yi; XU Li; ZHANG Yong; ZHENG Hong-liang
Source
医学研究生学报. 30(1):66-69
Subject
Language
Chinese
ISSN
1008-8199
Abstract
目的：临床上对于抑酸治疗控制声带白斑的必要性还存在争议。文中旨在通过观察咽喉反流对声带白斑术后相关症状的影响，探讨咽喉反流在声带白斑进展中的作用，明确抑酸治疗在声带白斑治疗中的重要性。方法选取2013年6月至2015年12月在南京军区南京总医院耳鼻咽喉头颈外科行声带白斑手术切除的患者97例。根据24 h测酸结果将声带白斑患者分为反流组（ n＝26，咽喉反流）与非反流组（ n＝71，咽喉未反流）。并采用随机数字表法将反流组患者随机分为抑酸治疗组（ n＝13，口服埃索美拉唑）和非抑酸治疗组（ n＝13，口服安慰剂）。所有患者于术前和术后8周记录电子喉镜、嗓音障碍指数-10量表（ VHI-10）、反流性喉炎症状指数量表（ RSI）以及体征指数量表（ RFS）结果并进行比较，观察咽喉反流及抑酸治疗对声带白斑术后症状的影响。结果反流组术后8周RSI、RFS较术前明显降低[（13．6±5．8）分 vs （18．2±6．2）分，（9．2±2．4）分vs （10．6±2．8）分，P＜0．05]。反流组手术前后RSI、RFS差值较非反流组增大[（5．8±1．4）分 vs （2．3±0．8）分，（1．2±0．6）分vs （0．5±0．2）分，P＜0．05]。抑酸治疗组手术前后RSI、RFS差值较非抑酸治疗组增大[（6．6±1．2）分 vs （0．8±0．6）分；（2．6±0．6）分vs （0．5±0．3）分，P＜0．05]。抑酸治疗组术后8周VHI-10较术前明显降低[（12．6±3．6）分 vs （15．2±4．2）分，P＜0．05]。结论伴有咽喉反流的声带白斑患者给予正规的质子泵抑制剂治疗，可以减轻咽喉反流的症状，并有效地改善声音嘶哑。
[Abstract ] Objective Clinically, the necessity of acid suppression treatment in vocal leukoplakia is still controversial .This paper aims to investigate the roles of LPR in the pathogenesis and pathological process of vocal leukoplakia , and to clear the signifi-cance of acid suppression in the treatment of this disease through observing the influence of laryngopharyngeal reflux ( LPR) on the symptoms of postoperative vocal leukoplakia . Methods We collected 97 cases underwent vocal leukoplakia surgery from June 2013 to December 2015 in the Department of Otorhinolarygology Head and Neck Surgery , Nanjing General Hospital of Nanjing Military Re-gion.According to the results of ambulatory 24-hour double probe ( simultaneous esophageal and pharyngeal ) pH monitoring ( pH-me-try), the patients with vocal leukoplakia were divided into LPR group (n=26, laryngopharyngeal reflux) and non-LPR group(n=71, non-laryngopharyngeal reflux).Meanwhile, the patients in LPR group were then randomly divided into acid-suppressing group(n=13, oral esomeprazole ) and non-acid-suppressing ( n=13, oral placebo ) . All patients received evaluation and compared by electrolaryngendo-scope, voice handicap index-10 ( VHI-10), reflux symptom index ( RSI) and reflux finding score ( RFS) before operation and 8 weeks after operation, and observe the effect of laryngopharyngeal reflux and acid suppression on the symptoms of postoperative vocal leukoplakia . Results RSI and RFS after operation were significantly lower than before operation in LPR group[(13.6±5.8) vs (18.2±6.2), (9.2±2.4) vs (10.6±2.8), P<0.05].The difference of RSI and RFS between before and after operation in LPR group was higher than the non-LPR group[(5.8±1.4) vs (2.3±0.8), (1.2±0.6) vs (0.5±0.2), P<0.05].The difference of RSI and RFS between before and after operation in acid-suppressing group was higher than the non-acid-suppressing group[(6.6±1.2) vs (0.8±0.6), (2.6±0.6) vs (0.5±0.3), P<0.05].VHI-10 after operation was significantly lower than before operation in acid-suppressing group[(12.6±3.6) vs (15.2±4.2), P<0.05] Conclusion Standard PPI administration to patients suffering from vocal leukoplakia accompanied with LPR can alleviate the symptoms of LPR and improve hoarseness .
[Abstract ] Objective Clinically, the necessity of acid suppression treatment in vocal leukoplakia is still controversial .This paper aims to investigate the roles of LPR in the pathogenesis and pathological process of vocal leukoplakia , and to clear the signifi-cance of acid suppression in the treatment of this disease through observing the influence of laryngopharyngeal reflux ( LPR) on the symptoms of postoperative vocal leukoplakia . Methods We collected 97 cases underwent vocal leukoplakia surgery from June 2013 to December 2015 in the Department of Otorhinolarygology Head and Neck Surgery , Nanjing General Hospital of Nanjing Military Re-gion.According to the results of ambulatory 24-hour double probe ( simultaneous esophageal and pharyngeal ) pH monitoring ( pH-me-try), the patients with vocal leukoplakia were divided into LPR group (n=26, laryngopharyngeal reflux) and non-LPR group(n=71, non-laryngopharyngeal reflux).Meanwhile, the patients in LPR group were then randomly divided into acid-suppressing group(n=13, oral esomeprazole ) and non-acid-suppressing ( n=13, oral placebo ) . All patients received evaluation and compared by electrolaryngendo-scope, voice handicap index-10 ( VHI-10), reflux symptom index ( RSI) and reflux finding score ( RFS) before operation and 8 weeks after operation, and observe the effect of laryngopharyngeal reflux and acid suppression on the symptoms of postoperative vocal leukoplakia . Results RSI and RFS after operation were significantly lower than before operation in LPR group[(13.6±5.8) vs (18.2±6.2), (9.2±2.4) vs (10.6±2.8), P<0.05].The difference of RSI and RFS between before and after operation in LPR group was higher than the non-LPR group[(5.8±1.4) vs (2.3±0.8), (1.2±0.6) vs (0.5±0.2), P<0.05].The difference of RSI and RFS between before and after operation in acid-suppressing group was higher than the non-acid-suppressing group[(6.6±1.2) vs (0.8±0.6), (2.6±0.6) vs (0.5±0.3), P<0.05].VHI-10 after operation was significantly lower than before operation in acid-suppressing group[(12.6±3.6) vs (15.2±4.2), P<0.05] Conclusion Standard PPI administration to patients suffering from vocal leukoplakia accompanied with LPR can alleviate the symptoms of LPR and improve hoarseness .