摘要
目的:观察抗反流治疗老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并发咽喉反流疾病(LPRD)的临床疗效,探讨影响疗效的相关因素。方法:对30例OSAHS并发LPRD患者采用Müller's实验结合螺旋CT、计算机处理系统测定其上呼吸道鼻咽区、腭后区、舌后区、会厌后区4个分区最窄平面的横截面积。以上患者均给予质子泵抑制剂(雷贝拉挫)20 mg/d、多潘立酮片10 mg/次,每日3次,持续治疗3个月后重复以上检查观察疗效。结果:30例老年患者治疗后回流总数、总回流时间、反流症状指数量表、反流体征量表得分与治疗前比较差异均有统计学意义(均P<0.05);呼吸紊乱指数与治疗前比较无统计学意义(P>0.05);阻塞性睡眠呼吸暂停显效及有效的老年患者治疗后鼻咽区、腭后区、舌后区、会厌后区横截面积均较治疗前增大,无效患者变化幅度不大。结论:抗反流治疗仅对60%的老年OSAHS并发LPRD患者有效;除咽喉反流疾病外,年龄、BMI以及病程可能是导致40%的老年OSAHS患者没有改善的原因。
Objective：To observe the clinical curative effect of anti-reflux treatment in the elderly patients with laryngopharyngeal reflux and obstructive sleepapnea hypopnea syndrome（OSAHS）and to explore the related influencing factors.Method：The cross-sectional area of the narrowest plane in the nasopharyngeal region,velopharyngealregion,glossopharyngeal region,and hypopharynx region were measured using Spiral CT combined with Müller＇s experiment and computer processing system.All the elderly patients were administered with proton pump inhibitors（rabeprazole sodium,20mg/d）and domperidone tablets（10mg×3/d）for 3 months.After treatment,repeat tests were performed to evaluate the therapeutic effects.Result：Before and after 3 months of treatment,significant difference was found in the total number of reflux,total reflux time,reflux symptom index and reflux symptoms scale（P〈0.05）,however,there＇s no significant difference in respiratory disorder index（P〉0.05）.After 3 months treatment,the cross-sectional area of those four structural regions were increased in different dgrees in the patients with reuced OSAHS,However,no significant changes in the cross sectional area was observed in the patients with unchanged OSAHS.Conclusion：Anti-reflux therapy has curative effect in only 60% of the elderly patients with laryngopharyngeal reflux and OSAHS.In addition to the laryngopharyngeal reflux disease,age,BMI and medical history might be the reasons that lead to the failure of the improvement in the other 40% of the elderly patients.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2016年第8期645-648,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
