声带息肉手术联合抗酸治疗反流性咽喉疾病合并声带息肉的预后影响

摘要

目的 探讨声带息肉手术联合抗酸治疗对咽喉反流病(LPR)合并声带息肉预后的影响,为LPR合并声带息肉的治疗提供理论基础.方法 本探究研究对象选择2014年10月-2016年10月期间于我院行声带息肉手术治疗的100例LPR合并声带息肉患者,将声带息肉手术术后未进行抗酸治疗治疗的46例患者设为对照组,术后采用抗酸治疗的54例患者设为观察组.分别比较治疗前后相关声学参数、反流症状指数(RSI)、反流检查计分(RFS)以及嗓音障碍指数(VHI-10).结果 两组治疗前后振幅微扰(Shimmer)、频率微扰(Jitter)、最长声时(MPT)、谐噪比(HNR)、声门噪声能量(NNE)差异显著,治疗后观察组NNE、MPT与对照组差异显著,有统计学意义(P<0.05);治疗前后RSI>13、RFS>7人数比例差异显著,观察组治疗后RSI>13、RFS>7人数比例差显著低于对照组(32.61%vs55.55%),观察组咽喉反流治疗有效率显著高于对照组(67.39%vs44.45%),有统计学意义(P<0.05);两组治疗前后VHI-10差异显著,治疗后观察组显著低于对照组[(5.43±1.32)vs(14.32±2.31)].结论 声带息肉手术联合抗酸治疗咽喉反流病合并声带息肉能够显著改善患者的反流症状,降低嗓音障碍对生活质量造成的影响,提高嗓音质量.%Objective To explore the prognosis of laryngeal polyp surgery combined with anti-acid treatment on laryngopharyngeal reflux (LPR) in association with vocal cord polyp, so as to provide evidence for treatment of LPR in association with vocal cord polyp. Method Since October 2014 to October 2016, 100 cases of patients with LPR in association with vocal cord polyp treated with laryngeal polyp surgery in our hospital were selected as the object of study. After laryngeal polyp surgery, 46 cases without anti-acid treatment were set as control group, while the rest 54 cases with anti-acid treatment were set as observation group. Acoustic parameters, reflux symptom index (RSI), reflux finding score (RFS) and voice handicap index were respectively compared before and after treatment (VHI-10). Results There were significant differences in Shimmer, Jitter, MPT, HNR, NNE between two groups before and after treatment . After treatment, there were significant differences in NNE and MPT between two groups (P<0.05). There was significant difference in number of people with RSI>13 and RFS>7 before and after treatment. After treatment, the proportion of number of people with RSI>13 and RFS>7 in observation group was dramatically lower than that of control group (32.61% vs. 55.55%). The effective rate of LPR treatment of observation group was significantly higher than that of control group (67.39% vs. 44.45% , P<0.05). There was significant difference in VHI-10 between two groups before and after treatment, and that of observation group was dramatically lower than that of control group after treatment (5.43 ±1.32 vs. 14.32 ±2.31). Conclusion Laryngeal polyp surgery combined with anti-acid treatment can significantly improve symptoms of patients with LPR in association with vocal cord polyp. It can also relieve impacts of voice disorder on quality of life and improve voice quality.