摘要
目的分析腺样体肥大(adenoid hypertrophy,AH)患者的临床表现及病理学特征,观察咽喉反流与其病情严重程度的相关性。方法选取广东中山小榄人民医院2020年6月—2021年6月收治的接受手术治疗的AH患者150例。根据患者鼻腔中腺样体堵塞情况,将其分为轻度组(50例,腺样体堵塞后鼻孔1/3的位置)、中度组(50例,腺样体堵塞后鼻孔1/2的位置)和重度组(50例,腺样体堵塞后鼻孔2/3及以上的位置)3组,分析3组患者的临床特点。采用咽喉反流症状指数量表(RSI)、咽喉反流体征量表(RFS)比较3组患者咽喉反流情况,经Spearman系数分析RFS、RSI与AH患者病情严重程度的相关性。结果重度AH患者的免疫组化结果呈强阳性,临床多伴有严重鼻塞、打鼾症状,中度、轻度组的免疫组化阳性表达较弱、症状较轻;重度组患者的RSI、RFS评分均高于中度组、轻度组,差异有统计学意义(P<0.05);Spearman相关性分析显示,RFS、RSI评分越高,AH患者病情越严重,咽喉反流程度与腺样体肥大分级密切相关[r_((轻度与1级、2级、3级、4级))=0.472、0.365、0.262、0187,r_((中度与1级、2级、3级、4级))=0.583、0.332、0.243、0.143,r_((重度与1级、2级、3级、4级))=0.631、0.235、0.161、0.131,P<0.05]。结论不同病情严重程度的AH患者临床症状、病理学特征均存在一定差异,咽喉反流与AH病情密切相关,咽喉反流程度越高、腺样体肥大患者的病情越重。
Objective To analyze the clinical and pathological features of patients with adenoid hypertrophy(AH),and observe the correlation between pharyngolaryngeal reflux and the severity of the disease.Methods 150 patients with AH who received surgical treatment from Zhongshan Xiaolan People's Hospital in Guangdong Province from June 2020 to June 2021 were selected.According to the situation of adenoid blockage in the nasal cavity of the patients,they were divided into three groups:mild group(50 cases,1/3 of the position of the nostril after adenoid blockage),moderate group(50 cases,1/2 of the position of the nostril after adenoid blockage)and severe group(50 cases,2/3 of the position of the nostril after adenoid blockage),and the clinical characteristics of the three groups were analyzed;the laryngopharyngeal Reflux Symptom Index(RSI)and laryngopharyngeal Reflux Finding Score(RFS)were used to compare the situation of laryngopharyngeal reflux in three groups of patients,and the correlation between RFS,RSI and the severity of AH patients was analyzed by Spearman coefficient.Results The immunohistochemical results of the patients with severe AH were strongly positive,and the clinical symptoms were mostly accompanied by severe nasal congestion and snoring.The immunohistochemical positive expression of the moderate and mild groups was weak,and the symptoms were mild;the RSI and RFS scores of patients in the severe group were higher than those in the moderate group and the mild group,and the difference was statistically significant(P<0.05);Spearman correlation analysis showed that the higher the RFS and RSI scores,the more serious the condition of AH patients.The degree of pharyngolaryngeal reflux was closely related to the grading of adenoid hypertrophy[r_((mild and grade 1,grade 2,grade 3,grade 4))=0.472,0.365,0.262,0187,r_((moderate and grade 1,grade 2,grade 3,grade 4))=0.583,0.332,0.243,0.143,r_((severe and grade 1,grade 2,grade 3,grade 4))=0.631,0.235,0.161,0.131;P<0.05].Conclusion There are certain differences in clinical symptoms and pathological characteristics of AH patients with different disease severity.Pharyngeal reflux is closely related to the condition of AH.The higher the degree of laryngopharyngeal reflux,the more serious the condition of adenoid hypertrophy patients.
作者
刘伟清
季永红
张国华
LIU Weiqing;JI Yonghong;ZHANG Guohua(Department of Otolaryngology,Xiaolan People's Hospital,Zhongshan,Guangdong Province,528400 China)
出处
《系统医学》
2023年第3期167-170,193,共5页
Systems Medicine
基金
中山市医学科研项目(2021A020350)。
关键词
咽喉反流
腺样体肥大
病理学特征
临床表现
相关性分析
Throat reflux
Adenoid hypertrophy
Pathological characteristics
Clinical manifestation
Correlation analysis
