食管外反流诊断过程中不同诊断方法的相互关联及敏感性比较

K. Lukacova, Zuzana Javorská, M. Tedla
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摘要

食道外反流在耳鼻喉科门诊相对常见。本研究的目的是比较不同诊断方法在食管外反流诊断过程中的相互关联和敏感性(反流症状指数- RSI、反流发现评分- RFS、口咽ph测定RESTECH Dx-pH系统、诊断-治疗试验- DTT)。材料和方法:纳入30例患者。其中20例经口咽ph测定证实为返流,10例为阴性。每位患者完成RSI问卷,接受喉镜检查,口咽pH测量RESTECH Dx-pH系统和质子泵抑制剂诊断治疗试验,无论口咽pH测量结果如何,均持续3个月。研究了RESTECH Dx-pH系统对口咽ph测定的耐受性。另一个目的是利用描述性分析捕捉数据中的主要趋势,并利用推理分析获得关于个体诊断方法和患者特征之间内在关系的一般结论。结果:本组患者对RESTECH Dx-pH系统的耐受性为97.14%。相关指数表明单个方法的结果之间可以忽略不计或只有非常弱的关联。通过估计发病率进行推理分析,多达三种双组合显示出相同程度的阳性(82,90%;95% ci 70,5 - 95,3%)。即RSI × DTT、RFS × DTT和pH-metry × DTT。结论:RESTECH Dx-pH系统-口咽ph测定法是一种适合与其他方法联合诊断食管返流的诊断方法,患者耐受性好。然而,它在诊断EER中的单独使用在其他一些作品中受到质疑,这可以被认为是工作的局限性。主观和客观诊断方法结合诊断诊断治疗试验的并行使用是识别食管外返流患者的一种敏感方法。关键词:口咽ph -诊断-治疗试验-反流发现评分-反流症状指数-食管外反流
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Comparison of mutual associations and sensitivity of individual diagnostic methods in the process of identification of extraesophageal reflux
Introduction: Extraesophageal refl ux is relatively common in ENT outpatient offi ces. The aim of the study is to compare the mutual associations and sensitivity of individual dia gnostic methods in the process of identifi cation of extraesophageal refl ux (Refl ux Symptom Index – RSI, Refl ux Finding Score – RFS, oropharyngeal pH-metry RESTECH Dx-pH System, dia gnostic-therapeutic test – DTT). Material and methods: The study included 30 patients. In 20 of them refl ux was demostrated by oropharyngeal pH-metry, in 10 the pH-metry was negative. Each patient completed an RSI questionnaire, underwent video-laryngoscopic examination, oropharyngeal pH measurement RESTECH Dx-pH System and dia gnostic-therapeutic test using proton pump inhibitors for 3 months regardless of the result of oropharyngeal pH-metry. The tolerance of the oropharyngeal pH-metry RESTECH Dx-pH System was investigated. Another aim was to capture the main trends in the data using descriptive analysis and to obtain general conclusions about the internal relations between individual dia gnostic methods and patient characteristics using inferential analysis. Results: The tolerance of oropharyngeal pH-metry RESTECH Dx-pH System in our patient group was 97.14%. Correlation indices indicate negligible or only very weak associations between the results of individual methods. Based on inference analysis performed by estimating the incidence, up to three double combinations showed the same degree of positivity (82,90%; 95% CI 70,5–95,3%). Namely, they are RSI × DTT, RFS × DTT and pH-metry × DTT. Conclusion: The RESTECH Dx-pH System – oropharyngeal pH-metry is a suitable dia gnostic method in combination with other methods used in the dia gnosis of esophageal refl ux due to the good tolerance by patients. However, its separate use in the dia gnosis of EER is questioned in several other works which can be considered a limitation of the work. The parallel use of subjective and objective dia gnostic methods in combination with a dia gnostic-therapeutic test is a sensitive way of identifying patients with extraesophageal refl ux. Keywords: oropharyngeal pH-metry – diagnostic-therapeutic test – Reflux Finding Score – Reflux Symptom Index – extraesophageal reflux
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