窄带成像技术在诊断儿童咽喉反流中的应用
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徐州医科大学附属医院耳鼻喉科

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江苏省中医药科技发展计划项目(QN202009)


Application of narrowband imaging in diagnosis of laryngopharyngeal re?ux disease in children
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    目的 研究NBI技术在诊断儿童LPRD的准确性。方法 选取2021年1月~2021年7月间,因慢性扁桃体炎或扁桃体肥大在我院施行扁桃体切除手术的4~16岁儿童60例,在耳鼻喉医师的指导下,患儿和其父母共同填写《反流症状指数评分量表(RSI)》,并由2名耳鼻喉科专业医生填写《反流体征评分量表(RFS)》,切除的扁桃体组织进行免疫组织化学分析,观察扁桃体组织中胃蛋白酶(Pepsin)的表达情况。结果 RSI>13分22例(36.7%),RSI≤13分38例(63.3%),RFS>7分35例(58.3%),RFS≤7分25例(41.7%),Pepsin(+)39例(65%),Pepsin(-)21例(35%)。RSI评分在有无咽喉反流的比较,两者差异无统计学意义(P>0.05),RFS评分在有无咽喉反流的比较,两者差异具有统计学意义(P<0.05)。普通白光和NBI两种模式下进行RFS评分的比较,差异具有统计学意义(P<0.05),其中在声带水肿、喉粘膜弥漫性水肿、充血和红斑方面差异较显著。结论 NBI视图比普通白光视图更容易识别声带水肿、喉粘膜弥漫性水肿、充血和红斑等RFS参数,能够提高儿童LPRD诊断的准确性。

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    Objective To study the accuracy of NBI technique in diagnosing LPRD in children.Methods From January 2021 to July 2021, 60 children aged 4 to 16 who underwent tonsillectomy in our hospital for chronic tonsillitis or hypertrophy were recruited. Parents and children filled in the Reflux Symptom Index Scoring Scale (RSI) together , and 2 otolaryngologist filled in the Reflux Signs Scoring Scale (RFS).Results As aa result RSI > 13 in 22 cases (36.7%), RSI≤13 in 38 cases (63.3%),RFS > 7 in 35 cases (58.3%),RFS≤7 in 25 cases (41.7%), Pepsin (+) in 39 cases (65%), Pepsin (-) in 21 cases (35%).There was no significant difference in RSI score with or without laryngopharyngeal reflux (P > 0.05), and there was significant difference in RFS score with or without laryngopharyngeal reflux (P < 0.05).The comparison of RFS score between ordinary white light and NBI showed statistically significant difference (P < 0.05), among which, there were significant differences in vocal cord edema, diffuse edema of laryngeal mucosa, hyperemia and erythema.Conclusion Compared with white light, NBI view can identify RFS parameters such as vocal cord edema, diffuse laryngeal mucosa edema, hyperemia and erythema more easily, which can improve the accuracy of LPRD diagnosis in children.

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  • 收稿日期:2021-10-27
  • 最后修改日期:2021-11-30
  • 录用日期:2021-12-02
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