Research On The Relationship Between Children’s Laryngopharyngeal Reflux And Respiratory Disease

Objective:This study had summarized the pathology,clinical manifestations,diagnosis,treatment and outcome of children’ s Laryngopharyngeal reflux(LPR),and researched on the relationship between children’s respiratory diseases with LPR.The disease of children’ s respiratory system is common in children’ s hospital.A part of children can’t get satisfactory results through traditional diagnosis and treatment.Through the study,it is suggested there were a considerable part of refractory respiratory diseases are related to LPR.This study can help pediatricians learn and diagnose LPR in a better way.Methods:1.From September 2015 to December 2019,there were 174 children whose symptoms can’t be controlled by routine treatments in Capital Institute of Pediatrics,The main diagnoses of children were as follows:asthma(including cough variant asthma),chronic cough,unknown causes of cough and asthma,adenoid hypertrophy.All the children in the group had got their parents’understanding.Then we summarized the characteristics of LPR in these children.2.We mainly researched the clinical manifestations of LPR and the relationship between LPR and respiratory diseases.3.The children with LPR were given lifestyle adjustment and diet guidance,which on the basis of continuing to standardize the treatment of the original respiratory system diseases.Whether add drug treatment according to the situation of the symptoms.After 1 month,the curative effect was evaluated according to the change of clinical symptoms.Results:① There were 169 effective cases,including 95 boys and 74 girls.The age in a range from 1 month to 18 years old,the median age was 6.5 years,there were 33 children(19.53%)in the group of 1-month-old<age≤3-year-old,31children(18.34%)in the group of 3-year-old<age≤6-year-old,93 children(55.03%)in the group of 6-year-old<age≤12-year-old and 12 children(7.1%)in the group of 12-year-old<age≤18-year-old.②There were 32 children were monitored for positive results,the incidence of LPR was 18.6%.There 21 boys(65.62%)and 11 girls(34.38%).No significant statistical difference in the incidence of LPR between two different genders(X2=1.6,P=0.206).③The incidence of LPR is different in different age groups(X2=7.758,P=0.044).The incidence of LPR in preschool children is higher than that of school-age children④The main diagnoses of children with LPR were as follows:asthma(including cough variant asthma),chronic cough,unknown causes of cough and asthma,adenoid hypertrophy.⑤The incidence of LPR in different respiratory system diseases is different,which had significant statistical difference(X2=11.203,P=0.017).The incidence of LPR in the asthma group was higher than that in the chronic cough group,with significant statistical difference(X2-6.672,P=0.013).The incidence in unknown causes of cough and asthma was higher than that in chronic cough group,with significant statistical difference(P=0.01).⑥32 cases of LPR were intervened on the basis of the original treatment unchanged:they were all given lifestyle adjustment and diet guidance,Children with significant increase of Ryan index(>30)and/or long duration of LPR clinical manifestations and/or obvious symptoms were treated with domperidone(5-7 days)and/or omeprazole orally(4-8 weeks)⑦One month later,there were 11 children with LPR were cured,21 were improved,and no cases were not cured.The incidence of reflux in standing position was 100%while in lying position was 9.4%,Ryan value in standing position is higher than that in lying position.Conclusion:The incidence of LPR in children is not low.The incidence of LPR in preschool children is higher than that of school-age children..There is no significant difference in LPR’s incidence among different gender.The incidence rate of LPR in different respiratory diseases is different.The unknown causes of cough and asthma group was higher than the chronic cough group,and the asthma group was higher than the chronic cough group.After active treatment,LPR can be relieved obviously.The clinical manifestations of LPR are various.In the long-term standardized treatment of children with asthma,chronic cough,unknown causes of cough and asthma,adenoid hypertrophy,if the clinical performance does not improve significantly,clinicians should consider the possibility of LPR.Most of the reflux of LPR occurred in standing position.The acceptance of 24-hour laryngopharyngeal pH monitoring is very high,and the adverse reactions of children are few,and children of all ages can tolerate it.