持续使用PPI和消化肠道评估,经过负pH研究,在患有可能源于食道外GERD的喉症状的患者中继续使用PPI和消化肠道评估
D L Cohen1, V Richter1, A Mari2
1The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel and The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Acta gastro-enterologica Belgica
|August 30, 2024
概括
对食道外胃肠逆流病 (EE-GERD) 的前期pH测试并不能防止使用质子抑制剂 (PPI) 或减少胃肠道检查,这与指导方针相反. 许多EE-GERDpH测试阴性的患者继续使用PPI和GI随访.
科学领域:
- 胃肠病学 胃肠病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 目前的指导方针建议先进行pH测试,以检测食道外胃肠回流性疾病 (EE-GERD) 的症状.
- 这种方法假设负测试减少了进一步的胃肠道 (GI) 调查和质子抑制剂 (PPI) 的使用,从而可能降低成本.
研究的目的:
- 为了评估前期pH测试对单独出现EE-GERD症状的患者的实际影响.
- 确定负pH值研究是否导致GI调查和PPI处方减少.
主要方法:
- 对59名患者进行了回顾性研究,这些患者接受了针对疑似EE-GERD的PPI的24小时组合pH阻抗测试.
- 一个负面的研究被定义为DeMeester得分<14.7.7.
主要成果:
- 64.4%的患者有负pH值研究;喉腔镜检查结果没有预测结果.
- 与积极研究的患者相比,负面研究的患者有类似的胃肠道随访率,重复内镜检查和重复pH研究.
- 尽管检测结果呈阴性,但47.4%的患者在平均随访时间为43.6个月后仍在使用PPI;鼻后滴水或鼻炎的诊断与较低的PPI持续时间有关.
结论:
- 在EE-GERD中进行负pH测试并不能始终减少PPI使用或GI随访.
- 这些发现挑战了预先在怀疑EE-GERD时进行pH测试的成本效益和建议.
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