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Predictors of reflux aspiration and laryngo-pharyngeal reflux.

反流误吸和喉-咽反流的预测因素。

  • 影响因子:1.78
  • DOI:10.1007/s10388-020-00726-9
  • 作者列表:"Khoma O","Burton L","Falk MG","Van der Wall H","Falk GL
  • 发表时间:2020-02-21
Abstract

BACKGROUND:Gastro-esophageal reflux disease (GERD) can present with typical or atypical or laryngo-pharyngeal reflux (LPR) symptoms. Pulmonary aspiration of gastric refluxate is one of the most serious variants of reflux disease as its complications are difficult to diagnose and treat. The aim of this study was to establish predictors of pulmonary aspiration and LPR symptoms. METHODS:Records of 361 consecutive patient from a prospectively populated database were analyzed. Patients were categorized by symptom profile as predominantly LPR or GERD (98 GER and 263 LPR). Presenting symptom profile, pH studies, esophageal manometry and scintigraphy and the relationships were analyzed. RESULTS:Severe esophageal dysmotility was significantly more common in the LPR group (p = 0.037). Severe esophageal dysmotility was strongly associated with isotope aspiration in all patients (p = 0.001). Pulmonary aspiration on scintigraphy was present in 24% of patients. Significant correlation was established between total proximal acid on 24-h pH monitoring and isotope aspiration in both groups (p < 0.01). Rising pharyngeal curves on scintigraphy were the strongest predictors of isotope aspiration (p < 0.01). CONCLUSIONS:Severe esophageal dysmotility correlates with LPR symptoms and reflux aspiration in LPR and GERD. Abnormal proximal acid score on 24-h pH monitoring associated with pulmonary aspiration in reflux patients. Pharyngeal contamination on scintigraphy was the strongest predictor of pulmonary aspiration.

摘要

背景: 胃食管反流病 (GERD) 可表现为典型或非典型或喉咽反流 (LPR) 症状。反流病的肺吸入是反流病最严重的变异之一,其并发症难以诊断和治疗。本研究的目的是建立肺吸入和LPR症状的预测因子。 方法: 分析来自前瞻性填充数据库的 361 例连续患者的记录。患者按症状特征分类主要为LPR或GERD (98 GER和 263 LPR)。对症状表现、pH研究、食管测压和闪烁扫描及其关系进行了分析。 结果: 重度食管动力障碍在LPR组更为常见 (p = 0.037)。所有患者的严重食管动力障碍与同位素抽吸强烈相关 (p = 0.001)。24% 的患者在闪烁扫描时出现肺穿刺。两组 24 h pH监测总近端酸与同位素抽吸之间均建立显著相关性 (p <0.01)。闪烁扫描咽部曲线上升是同位素吸入的最强预测因子 (p <0.01)。 结论: 严重的食管动力障碍与LPR和GERD的LPR症状和反流误吸相关。反流患者 24 h pH监测中与肺误吸相关的近端酸评分异常。闪烁扫描时咽部污染是肺误吸的最强预测因子。

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影响因子:1.24
发表时间:2020-01-01
DOI:10.3892/etm.2019.8190
作者列表:["Shang L","Pei QS","Xu D","Liu JY","Liu J"]

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影响因子:2.64
发表时间:2020-01-01
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