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如果您有声音嘶哑、慢性咽喉痛、夜间干咳或感觉喉咙有痰但不明原因，这些症状可能与“胃酸反流至喉咙”，也称为 喉咽反流（Laryngopharyngeal Reflux, LPR）有关，这与一般的胃食管反流病（GERD）不同，因为通常不会表现为胸口灼热感，因此常被忽视且未能及时诊断 
 
喉咽反流（Laryngopharyngeal Reflux, LPR），又称为“无声反流”，是指胃酸从胃部反流至喉咙、声带和咽部，但不像一般的胃食管反流病（GERD）那样表现为胸口灼热感，因此许多患者并未意识到自己正面临需要及时处理的健康问题
 
常见的胃酸反流至喉咙的症状，即使没有明显的胸口灼热感，以下症状可能是LPR 
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">持续性声音嘶哑，尤其是早晨</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">喉咙有黏痰，需频繁清嗓</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">无明显原因的慢性咳嗽</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">持续性咽喉痛或刺激感</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">吞咽困难或感觉喉咙有异物感</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">有时呼吸不畅</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">喉咙有酸或苦味，尤其是醒来时</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">口气异味</li>
</ul>
<h2></h2>
<h2>LPR 与胃食管反流病（GERD）的区别？ </h2>
胃食管反流病（GERD）是胃酸反流至食管，导致胸口灼热、反酸或胸闷等症状，但在LPR中，胃酸和胃液反流至气管、喉咙或声带，导致上呼吸道系统的慢性症状，而不会像GERD 胸口灼热感
 
<h2>原因及风险因素 </h2>
主要原因是上食管括约肌（Upper Esophageal Sphincter）和下食管括约肌（Lower Esophageal Sphincter）功能异常，这些括约肌负责阻止胃液反流。如果括约肌功能异常，胃液就可能反流至咽部和声带。诱发LPR的因素包括 
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="9" data-aria-level="1">食管括约肌功能异常</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="9" data-aria-level="1">胃内压力升高，如进食大量食物后</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="9" data-aria-level="1">吸烟、饮酒或含咖啡因饮料</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="9" data-aria-level="1">肥胖或超重</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="9" data-aria-level="1">餐后立即平躺 </li>
</ul>
 
<h2>可能出现的并发症 </h2>
如果长期不治疗，可能导致其他问题，例如 
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">声带慢性炎症</li>
<li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">声带纤维化或肿块形成</li>
<li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">声音永久改变</li>
<li data-leveltext="" data-font="Symbol" data-listid="3" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">长期增加食管或咽喉癌风险 </li>
</ul>
<h2></h2>
<h2>诊断方法 </h2>
医生会详细询问症状，可能会通过鼻腔或喉咙镜检查（柔性喉镜检查，Flexible Laryngoscopy）观察声带或咽喉的炎症情况，此外可能会考虑进行食管酸度监测，或使用专门针对胃酸反流至喉咙的症状评估量表
 
<h2>LPR 的治疗方法 </h2>
1. 行为调整 
<ul>
<li data-leveltext="o" data-font="Courier New" data-listid="4" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="2">避免引起反流的食物或饮料，如油炸食品、巧克力、咖啡</li>
<li data-leveltext="o" data-font="Courier New" data-listid="4" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="2">适量进食，睡前至少间隔3小时</li>
<li data-leveltext="o" data-font="Courier New" data-listid="4" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="2">将床头抬高约6–8英寸</li>
<li data-leveltext="o" data-font="Courier New" data-listid="4" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="2">如果超重，应减轻体重 </li>
</ul>
2. 药物治疗 
<ul>
<li data-leveltext="o" data-font="Courier New" data-listid="4" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="2">抗酸药（Antacids）</li>
<li data-leveltext="o" data-font="Courier New" data-listid="4" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="2">抑制胃酸分泌的药物，如质子泵抑制剂（Proton Pump Inhibitors, PPI）或H2受体拮抗剂 
（用药应遵医嘱） </li>
</ul>
3. 症状追踪
LPR的治疗可能比一般胃食管反流病更长，患者应持续与医生跟进，以调整治疗方案，确保适合个人情况
&nbsp;
<h2>不要忽视轻微症状，因为它们可能是疾病的“无声信号” </h2>
如果您有声音嘶哑、慢性咳嗽、咽喉痛或喉咙有异物感，且症状持续2–4周未消失，应尽快就诊耳鼻喉专科医生进行评估和诊断。若不治疗，可能导致并发症，如声带慢性炎症、声带息肉（Vocal cord polyp）、慢性咳嗽影响日常生活，或增加慢性食管炎风险 
 
胃酸反流至喉咙（LPR）初期可能不严重，但若未得到适当照护，可能影响生活质量。如果您有声音嘶哑、慢性咽喉痛或不明原因的干咳，可能是胃酸反流至喉咙的信号，请勿让这些症状长期影响您的生活质量 
 
建议您接受耳鼻喉专科团队在帕亚泰2医院耳鼻喉中心的专业评估和针对性治疗，该中心提供咨询、诊断及个性化治疗方案，帮助您恢复最佳生活状态 
 
&nbsp;
副教授 医师 吉提·坎博塔猜
耳鼻喉中心主任
帕亚泰2医院

声音嘶哑、慢性咳嗽、喉咙痛不愈，可能不仅仅是慢性感冒，而可能是“咽喉反流病”（LPR），这是一种通常不会表现出像普通胃酸反流那样的胸口灼热症状的疾病，导致许多人不知道自己患病。如果不及时治疗，可能会引发长期并发症。建议到耳鼻喉专科医生处进行检查和治疗，以针对性地恢复生活质量，地点为帕亚泰2医院。

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胃液倒流回喉咙，这是一种你可能不知道的疾病

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