王科　刘兆辉

【摘要】 喉咽返流疾病（LPRD）是指胃内容物反流至食管上括约肌以上部位，引起一系列症状和体征的总称，LPRD已经涉及多种儿科疾病，比如喉软骨软化病、复发性呼吸道乳头瘤样增生、慢性咳嗽、哮喘、声嘶、食管炎、腺样体肥大、扁桃体肥大、中耳炎、鼻窦炎、导致咽鼓管疾病进而引起的的听力损害等，被认为是导致小儿未能茁壮成长的一个重要原因。目前认为，近年来，喉咽反流对小儿上气道的影响已经越来越受到临床的重视，虽然喉咽反流（LPR）在与小儿上气道疾病关系方面存在诸多问题需要研究，但其在耳鼻喉头颈外科疾病中的致病作用越来越受到国内学者的关注，很多医师对该病还不甚了解或知之甚少，故对近年来喉咽反流与小儿上气道疾病的关系研究做一综述。

【关键词】喉咽反流；腺样体肥大；鼻窦炎；哮喘；小儿

【Abstract】： Laryngopharyngeal reflux disease （LPRD） refers to the stomach contents reflux to the esophageal sphincter， the above parts， cause a series of the floorboard of the symptoms and signs， LPRD has been involved in many diseases in pediatrics， such as laryngeal cartilage softening disease， recurrent respiratory papilloma hyperplasia， chronic cough， asthma， hoarseness， esophagitis， adenoid hypertrophy， otitis media， sinusitis， and cause disease in the eustachian tube， in turn， cause of hearing impairment， etc.， are considered to be an important cause of the children with failure to thrive.Now think that， in recent years， of laryngopharyngeal reflux affect on pediatric airway has been more and more get the attention of the clinical， although of laryngopharyngeal reflux （LPR） in pediatric airway disease in relation to the many problems need to study， but its pathogenic role in the disease of ent head and neck surgery is more and more attention from domestic scholars， many physicians for the disease also don't know much or little， therefore， in recent years of laryngopharyngeal reflux relations with pediatric airway disease research.

【Keywords】： Laryngopharyngeal reflux；Adenoid hypertrophy.Sinusitis；Asthma；pediatric

【中图分类号】R725.6 【文献标识码】B【文章编号】1004-4949（2015）02-0786-01

①基金项目：胃内容物反流与小儿腺样体肥大的相关性研究，项目编号：CK-798

一、小儿LPR的特点与发病机制

该病是婴幼儿期常见病。儿童LPR的临床表现轻重不一，与年龄密切相关，无特异性。婴幼儿LPR主要表现为进食后呕吐、吞咽困难、呼吸暂停甚至危及生命、喉软化症等。反复呕吐可导致患儿营养不良、生长发育迟滞。学龄期儿童机青春期儿童LPR主要表现类似成年患者，包括慢性咳嗽、哮喘、声嘶、烟异感、反复上呼吸道感染等。LPR在新生儿及婴幼儿很常见，2/3患儿最初发生于4月龄，1岁时反流次数减少Nelson SP[1]，3～17岁的发生率是1.8%～8.2%Nelson SP[2]。……