The Search Of High Resolution Manometry Characteristics Of Patients With Laryngopharyngeal Reflux Disease (LPRD)

Background and purpose:In otolaryngology,laryngopharyngeal reflux disease(LPRD)very common.With the improvement require of the living standards and the quality of life,the outpatient rate of the disease increased year by year.The clinical study analyze and research the laryngopharyngeal ref high resolution manometry characteristics of the patients withlux disease(LPRD).At the same time,we can know the relationship between the LPRD and the quality of life.Methods:Select 68 cases from February 2015 to January 2017 who received treatment at the first hospital affiliated to dalian medical university otolaryngology department and digestive department,and complaint with Heartburn,acid reflux,belching,retrosternal burning sensation,pharynx foreign body sensation,etc.All the patients must completing the forms(throat reflux symptoms index scale(RSI)?SF-36 quality of life questionnaire)under the guidance of the staff,theso were trained unity.Divide into groups : Laryngopharyngeal reflux group and failed to reach diagnostic criteria of Laryngopharyngeal reflux group.All the patients involved in the research must finished the examine of HRM in the first hospital gastrointestinal chamber which affiliated to dalian medical university.Obvervational index: upper esophageal sphincter resting pressure(UESP),distal contraction integral(DCI),far end latencytime(DL)and lower esophageal sphincter resting pressure(LESP).Statistical analysis :with the spss20.0 statistical software to analyze the data,t test was adopted,when p < 0.05 think the difference has statistically significant.The results of the study:In the 68 cases,Laryngopharyngeal reflux group have 25 cases.accounted for36.8%.There are nine symptoms: hoarseness,much sputumor and nasal discharge flow back,breathing disorders,continuing to hawk,persistent cough,the cough relate to position or diet,swallowing food or drugs have obstruction,pharynx foreign body sensation,heartburn or stomachache.respectively proportion is: 56%,64%,68%,72%,76%,76%,80%,88%,96%.In the 68 cases,statistical comparison have no significant difference in age and BMI(P > 0.05)between the two groups.the quality life between the groups have statistically significant(P < 0.05),the quality life of the laryngopharyngeal reflux group obviously lower than the other group.The high resolution manometry datas of the two groups have no significant difference(P > 0.05).In the 25 cases which can be diagnosed LPRD,there are 11 cases(44%)performance : esophageal motility abnormalities,moreover,all are weakened(peristaltic disappear or invalid 7 cases,squirming big defect 1 case,little defect 3 cases).there are 14 cases(56%)have the low LESP,total distribution :11.50(7.90,15.55)mm Hg.there are 13cases(52%)have low UESP,total distribution :31.00(21.75,52.7)mm Hg.there are 1 case(4%)have the low DCI,total distribution: 2558.60(1426.75,3932.60)mm Hg.DL are within the normal range,total distribution: 6.93(6.46,7.42)mm Hg.In the 43 cases which failed to reach diagnostic criteria of Laryngopharyngeal reflux,there are 18 cases(41.7%)performance :esophageal motility abnormalities,moreover,all are weakened(peristaltic disappear or invalid 7 cases,squirming big defect 4case,little defect 7 cases).there are 23 cases(53%)have low LESP,total distribution : 11.00(7.00,20.00)mm Hg.there are 18cases(42%)have low UESP,total distribution : 37.00(24.00,45.00)mm Hg.DCI are within the normal range,total distribution: 2637.50(1864.10,3932.20)mm Hg.DL are within the normal range,total distribution: 7.13(6.48,7.90)mm Hg.Conclusion:1,In the patients who with the symptoms of reflux,36.8% can be diagnosed LPRD,and the symptoms: heartburn stomachaches,pharynx foreign body sensation,swallowing obstruction,and the cough relate to position or diet,continue cough,continue clear voice probability of occurrence are higher than others.2?The patients who can be diagnosed LPRD have littler quality life than the others.3?In the patients who with the symptoms of reflux,the total distribution of LESP and UESP of the two groups are close to the lower limit of normal.4 ? 40% patients who with reflux symptoms exist esophageal motility abnormalities,moreover,all are expression bradydiastalsis.