Preliminary Application Of Dx-pH Monitoring System In Children’s Laryngopharyngeal Reflux

ObjectiveTo evaluate the diagnostic values of Dx-pH monitoring system in laryngopharyngeal reflux,the consistency between Dx-pH monitoring and proton pump inhibitors test,provide reference for children’s laryngopharyngeal reflux diagnostic criteria.MethodsOutpatients in Shenzhen children’s hospital ENT department were selected January 2016 to December 2016.Children with The RSI > 13 and(or)RFS > 7 were included.A total of 59 cases were selected,on the basis of age,they were divided into preschool and school-age group.All the patients completed the Dx-pH detection,diet management and anti reflux treatmentt,every cases was followed up for at least 3 months,and observed reflux corresponding symptoms.During the study period,6 cases lost to follow-up,53 cases completed finally.Results53 cases were in accordance with the inclusive criteria including 39 males and 14 females.Preschool group included 29 cases,School age group included 24 cases.Many of them had the complications and usually accompanied by sinusitis,pharyngitis,adenoid hypertrophy,laryngitis,and otitis media.Whether they had complications,can not influence the treatment effect of LPR.(1)The RFS score before treatment,had no statistical difference between preschool and school-age group(P > 0.05),there was no statistically significant difference in frequency of different signs,The RSI score had no statistically significant difference(P > 0.05).(2)Taking Ryan index as diagnostic standard,15 patients were diagnosed with LPR(28.3%).41 cases(77.4%)had more then three times pH events,and 2 cases(3.8%)prompt basic reflux.(3)All the patients took proton pump inhibitors for 4 weeks,18 cases(34.0%)were effective,24 cases had improvement(45.3%),11 cases(20.8%)were ineffective,the overall effective rate was 79.3%.(5)PPI diagnostic test results were not in good accordance with Ryan index,but had medium consistency with pH events ≥3 times.Conclusion(1)Dx-pH monitoring system can accurately detect reverse reflux event,objectively confirmed the existence of the LPR.(2)Most children with LPR were usually complicated by other diseases.If patients had ineffective treatment to recurrent sinusitis,otitis media,complication by LPR should be noticed.(3)Most symptoms in children’s LPR were mild than those of adult,modification of diet and anti-reflux medication have obtained a better effect.(4)According to the symptoms and signs under laryngoscope,patients were considered to be diagnosed as LRP,reference pH events ≥3 times can help comprehensively assess patient′s condition when Ryan index and to the judgement standard of 24 h Dx-pH monitoring are not up to standard.