对流相关咳的诊断和管理方法
Ofer Z Fass1, Rena H Yadlapati2
11Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Gastroenterology & hepatology
|February 6, 2026
概括
慢性咳,影响全球10%,通常与胃食道逆流症 (GERD) 相关. 诊断是具有挑战性的,因为许多患有反流相关咳的患者没有典型的GERD症状.
科学领域:
- 胃肠病学和肺病学 胃肠病学和肺病学
背景情况:
- 慢性咳 (>8周) 影响全球10%的人口,显著降低生活质量.
- 胃食道逆流性疾病 (GERD) 是已知的慢性咳的原因,但该机制复杂,通常没有典型的GERD症状 (心烧,吐).
- 机制包括直接的反流刺激和阴道介导的食道-气管支气管反射;咳过敏会放大反流效应.
研究的目的:
- 审查反流相关慢性咳的诊断评估和管理策略.
- 突出由于非典型或缺少经典GERD症状而导致的诊断挑战.
- 讨论当前和潜在的未来方法来管理这种情况.
主要方法:
- 关于反流相关的慢性咳现有文献的综述.
- 讨论诊断方法,包括临床评估,经验试验和门诊逆流监测.
- 管理策略的概述,从生活方式的改变到手术干预.
主要成果:
- 高达75%的反流相关咳患者缺乏典型的GERD症状,使诊断复杂化.
- 在这些患者中,标准上部内镜检查结果通常是正常的.
- 建议采取逐步的管理方法,从生活方式和医疗疗法开始,向神经调节器或耐火病例的手术进展.
结论:
- 准确诊断反流相关的咳需要一个结构化的方法,整合各种方法.
- 有效的管理涉及一个逐步策略,根据个体患者的需求量身定制.
- 进一步开发诊断工具和临床指南对于改善患者的治疗结果至关重要.
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