74例咽喉反流患者抗反流黏膜切除术后2年临床疗效分析

doi:10.6040/j.issn.1673-3770.0.2024.185

Abstract

Abstract: Objective To evaluate the two-year clinical efficacy of endoscopic anti-reflux mucosectomy(ARMS)in the treatment of laryngopharyngeal reflux disease(LPRD). Methods A retrospective analysis was performed on 221 patients who underwent ARMS and had available follow-up data. All patients were diagnosed with LPRD by oropharyngeal pH monitoring. Comparisons were made between pre-operative and two-year post-operative Reflux Symptom Index(RSI)scores and 24-hour Dx-pH monitoring results to assess the efficacy of ARMS in the treatment of LPRD. Patients were also grouped by gastroesophageal valve(GEFV)grade to investigate the influence of GEFV on ARMS efficacy. Results 74 out of 221 patients were included in the study. RSI scores decreased significantly compared to preoperative values(P=0.005), with the most notable improvements observed in hoarseness/voice disorders, persistent throat clearing, difficulty swallowing food, liquids or pills, heartburn, chest pain and stomach pain(P=0.013, 0.04, 0.043, 0.02). According to the Dx-pH monitoring, the upright Ryan score decreased significantly compared to preoperative values(P<0.001). Patients with GEFV grades Ⅰ and Ⅱ showed a significant improvement in Ryan scores in the upright position postoperatively(P<0.05), while no significant changes were observed in Ryan scores in the supine position(P>0.05). In patients with GEFV grades Ⅲ and Ⅳ, no significant changes were observed in either the upright or supine Ryan scores postoperatively(P>0.05). Conclusion ARMS can effectively improve symptoms of LPRD and GEFV grading is valuable in predicting prognosis. Patients with GEFV grades Ⅰ and Ⅱ show significant symptom improvement, whereas patients with GEFV grades Ⅲ and Ⅳ show limited surgical benefit.

Key words: Anti-reflux Mucosectomy, Laryngopharyngeal Reflux Disease, Gastroesophageal Flap Valve Grading, Ryan Index, Dx-pH Monitoring

CLC Number:

R766.14

ZHANG Bin, CHEN Sheng, LI Bing, XI Xiaoyu, ZHONG Changqing, GAO Xiaopei, LI Lianyong, SUI Xinke. Analysis of the two-year clinical effectiveness of anti-reflux mucosectomy in 74 patients with laryngopharyngeal reflux[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 120-125.

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Analysis of the two-year clinical effectiveness of anti-reflux mucosectomy in 74 patients with laryngopharyngeal reflux

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