术前抑酸治疗对声带白斑患者疗效的影响

庄丕伟;黄永望;

1:天津医科大学第二医院耳鼻咽喉科

摘要
目的探讨术前抑酸治疗对声带白斑术后疗效的影响。方法将72例合并咽喉反流的声带白斑患者随机分为A(年龄32~65岁,平均41.2±3.5岁)、B(年龄29~61岁,平均44.6±4.5岁)两组,各36例;A组术前接受6~8周的质子泵抑制剂抑酸治疗,B组仅接受手术治疗。选择36例(年龄33~63岁,平均40.7±3.9岁)无咽喉疾病且声带正常的健康成年人为正常对照组。A组抑酸治疗前1天、A和B组患者手术前1天及术后1个月分别进行嗓音声学分析、嗓音障碍指数-10(voice handicap index-10,VHI-10)量表评估、反流症状指数(reflux symptom index,RSI)和反流体征评分(reflux finding score,RFS)量表的评估;对照组进行嗓音声学分析;比较A、B两组结果,并与对照组比较嗓音声学分析结果。结果 A组术前抑酸治疗后RSI、RFS、VHI-10评分较抑酸治疗前降低;基频微扰(jitter)、振幅微扰(shimmer)值降低,谐噪比(HNR)、嗓音障碍严重指数(dysphonia severity index,DSI)值升高,差异有统计学意义(P<0.05)。A组术后RSI、RFS、VHI-10评分均降至正常范围,jitter、shimmer、HNR、DSI值与正常对照组差异无统计学意义(P>0.05)。B组术后RSI、RFS、VHI-10评分较术前降低,jitter、shimmer值较术前降低,但仍高于对照组(P<0.05);HNR、DSI值较术前升高,但仍低于正常对照组(P<0.05)。A组患者抑酸治疗后,27例(75.0%,27/36)患者声带白斑范围缩小,术后1个月复查电子喉镜,A组患者无复发,B组有8例(22.22%,8/36)患者复发。结论术前抑酸治疗有利于促进声带白斑患者手术后的恢复。
关键词
声带白班;咽喉反流;抑酸治疗;嗓音分析
基金项目(Foundation):
作者
庄丕伟;黄永望;
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