窄带成像技术在儿童咽喉反流性疾病诊断中的应用价值研究

Research on the Application Value of Narrow Band Imaging Technology in the Diagnosis of Laryngopharyngeal Reflux Disease in Children

摘要:

目的 研究分析窄带成像（Narrow Band Imaging，NBI）技术在儿童咽喉反流性疾病（Laryngopharyngeal Reflux Disease，LPRD）诊断中的应用价值。 方法 选取2025年5月—2025年11月间于重庆市中医院耳鼻喉科就诊并诊断为扁桃体肥大和/或腺样体肥大的40例3-14岁患儿，接受唾液胃蛋白酶检测及白光/NBI喉镜检查，由2名耳鼻咽喉科专业医生填写反流体征评分量表(RFS)。 结果 40例患儿中唾液胃蛋白酶检测阳性27例（67.5%），白光下RFS>7分13例（32.5%），RFS≤7分27例（67.5%）；NBI模式下RFS>7分25例（62.5%），RFS≤7分15例（37.5%），两种模式评分具有差异（P<0.05）。白光和NBI两种模式在“红斑/充血”“声带水肿”“弥漫性水肿”的评分差异具有统计学意义（P=0.001）。NBI下杓间区棕色/红色斑点为11/40（27.5%）、舌根隐窝炎症为31/40（77.5%），咽后壁鹅卵石样征象37/40（92.5%）。咽后壁鹅卵石征分级与腺样体肥大程度之间无显著相关性（P=0.400）。 结论 NBI较普通白光更容易识别部分反流体征，能够提高儿童LPRD诊断的准确性。

Abstract:

Objective:To investigate and analyze the diagnostic value of Narrow Band Imaging (NBI) technology in the diagnosis of laryngopharyngeal reflux disease (LPRD) in children. Methods:Forty pediatric patients aged 3–14 years who were diagnosed with hypenrophy of tonsily and/or adenoid hypertrophy and visited the Department of Otolaryngology at Chongqing Traditional Chinese Medicine Hospital between May and November 2025 were enrolled.They underwent salivary pepsin testing and white-light/NBI laryngoscopy.There are two otolaryngologists completed the Reflux Findings Score (RFS) questionnaire. Results:27 patients tested positive for salivary pepsin of 40 patients; under white light, 13 patients had an RFS >7 (32.5%)and 27 had an RFS ≤7（67.5%）; under NBI mode, 25 patients had an RFS >7 （62.5%）and 15 had an RFS≤7（37.5%）. There was a statistically significant difference between the two modes (P < 0.05). The differences in scores between the white light and NBI modes for “erythema/hyperemia” “vocal cord edema” and “diffuse edema” were statistically significant (P=0.001). Under NBI, brown/red spots in the interarytenoid region were observed in 11/40 (27.5%) cases, inflammation of the lingual fossa was observed in 31/40 (77.5%) cases, and the cobblestone sign on the posterior pharyngeal wall was observed in 37/40 (92.5%) cases. There was no significant correlation between the grading of the posterior pharyngeal wall “pebble-like” sign and the degree of adenoid hypertrophy (P=0.400). Conclusion:NBI facilitates the identification of certain reflux signs more effectively than conventional white light, thereby improving the diagnostic accuracy of LPRD in children.