Study On Distribution Of Children’s Laryngopharyngeal Reflux In Respiratory Diseases

Objective:To study the morbidity and distribution characteristics of laryngopharyngeal reflux in respiratory diseases,and identify the risk factors contributed to laryngopharyngeal reflux,this study aimed to strengthen the understanding of pediatrician on laryngopharyngeal reflux and provide the basis for the prevention and treatment of laryngopharyngeal reflux.Method:From December 2015 to December 2017,we collected 97 patients with respiratory diseases from pediatric respiration specialist outpatient and inpatient treatment in the First Affiliated Hospital of Xiamen University.Using a United States throat pH detection system,we measured the throat pH for 24 hours for screening the laryngopharyngeal reflux children from these 97 patients.Children with laryngopharyngeal reflux were divided into groups by age(6 months to 3 years old,4-6 years old,≥ 7 years old),gender,and different respiratory diseases.In addition to the original treatment,we also have diet and antacid treatment for 4-8 weeks,and then the prognosis was evaluated according to related clinical symptoms such as cough score and asthma score.Result:(1)54 patients with laryngopharyngeal reflux were screened from the 97 patients with respiratory diseases,with a 55.67%detection rate of laryngopharyngeal reflux;Among the 54 children with laryngopharyngeal reflux,no statistically significant difference was found in the incidence rate between male and female groups(χ2=0.184,P=0.668).There was a statistically significant difference in the incidence rate of laryngopharyngeal reflux in different age groups(χ2=11.068,P=0.004).(2)The clinical symptoms of children with laryngopharyngeal reflux were as follows:cough,wheezing,phlegm sound,runny nose,stuffy nose,clear mulberry,sneezing,snoring,facial blush,paroxysmal facial cyanosis,vomiting,anorexia,abdominal pain,diarrhea,foamy mouth et al.Initial diagnoses included pneumonia,allergic rhinitis and sinusitis,asthma,chronic cough,trachea/bronchial softening et al.(3)There was a statistically significant difference in the detection rate of laryngopharyngeal reflux in different respiratory diseases(χ2=9.107,P=0.011).In the pneumonia group,the detection rate were higher than that of in the asthma group(χ2=7.583,P=0.006),and the asthma group was higher than the bronchial/tracheal softening group(χ2=4.44,P=0.035).(4)Loss of appetite,tracheal/bronchial softening,growth retardation,chronic cough,history of less than 6 months,low body weight,wheezing,school-aged children,phlegm sound were the risk factors of laryngopharyngeal reflux,but vomiting was not a risk factor for laryngopharyngeal reflux.(5)54 cases of children with laryngopharyngeal reflux were acidic reflux,and the reflux rate was 98.1%when they were in standing position.The Ryan value was significantly higher in standing position than in lying position(Z=-7.941,P<0.001).There was no statistically significant difference in Ryan values in standing positions among different age groups(H =0.717,P=0.699).(6)In addition to the original treatment,the children with throat reflux were also given diet and antacid treatment.The clinical symptom prognosis rate was 92.59%by follow-up observations.conclusion:The detection rate of children’s laryngopharyngeal reflux in children’s respiratory diseases was high,especially in children with chronic cough,wheezing,phlegm in throat and nasal congestion.(2)The occurrence of laryngopharyngeal reflux was related to age not to gender.(3)There were several risk factors in children with laryngopharyngeal reflux,such as loss of appetite,backward growth and development,tracheal softening,low body weight,wheezing,cough et al.(4)Active treatment of laryngopharyngeal reflux can improve the prognosis of primary respiratory diseases.