射频能量递送（Stretta手术）治疗反流性疾病中咽喉反流症状：一项系统评价。
Delivery of Radiofrequency Energy (Stretta Procedure) for Treating Laryngopharyngeal Reflux Symptoms in Reflux Disease: A Systematic Review.
文献信息
| PMID | 42722550 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jérôme R Lechien |
| 作者单位 | Department of Surgery, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France; Department of Otolaryngology-Head and Neck Surgery, Elsan Hospital, Paris, France; Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium. Electronic address: Jerome.Lechien@umons.ac.be. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本综述探讨了Stretta手术，即向胃食管交界处递送射频能量，对反流性疾病患者咽喉症状和表现的有效性。
方法： 在PubMed、Scopus和Cochrane Library中进行了PRISMA系统评价，以识别报告Stretta术后成人疑似或确诊咽喉反流病（LPRD）或胃食管反流病（GERD）咽喉症状或体征结局的前瞻性、回顾性和随机研究。使用Clarity Group工具和MINORS评估偏倚风险。
结果： 13项研究符合条件，包括7项前瞻性研究、4项回顾性研究和2项随机对照试验，代表848例反流性疾病患者。所有研究均纳入GERD伴咽喉症状的患者，但无一使用咽部pH-阻抗监测客观确认LPRD。咳嗽和声音嘶哑是最常评估的症状，在大多数病例系列中于3至12个月随访期间改善。现有数据还提示喘息或呼吸主诉改善。Stretta术后质子泵抑制剂停药率大致在40%至80%之间。未报告重大并发症。研究报告了纳入标准、咽喉症状结局和成功率定义的显著异质性。
结论： 当前证据不足以确定Stretta对GERD伴咽喉症状患者的有效性或适应症。未来的前瞻性对照研究应聚焦于使用动态咽部pH-阻抗监测客观确认LPRD的患者。
英文摘要
OBJECTIVE: This review investigated the effectiveness of the Stretta procedure, ie, radiofrequency delivery to the gastroesophageal junction, on laryngopharyngeal symptoms and findings in patients with reflux disease.
METHOD: A PRISMA systematic review was conducted in PubMed, Scopus, and the Cochrane Library to identify prospective, retrospective, and randomized studies reporting laryngopharyngeal symptom or sign outcomes after Stretta in adults with suspected or confirmed laryngopharyngeal reflux disease (LPRD) or gastroesophageal reflux disease (GERD). Risk of bias was assessed using the Clarity Group tool and MINORS.
RESULTS: Thirteen studies, including 7 prospective studies, 4 retrospective studies, and 2 randomized controlled trials, were eligible, representing 848 patients with reflux disease. All studies included patients with GERD and laryngopharyngeal symptoms, but none objectively confirmed LPRD using pharyngeal pH-impedance monitoring. Cough and hoarseness were the most frequently assessed symptoms and improved in most case series over 3- to 12-month follow-up. Available data also suggested improvement in wheezing or breathing complaints. Proton pump inhibitor discontinuation rates after Stretta ranged roughly from 40% to 80%. No major complications were reported. Studies reported significant heterogeneity for inclusion criteria, laryngopharyngeal symptom outcomes, and success rate definition.
CONCLUSION: Current evidence is insufficient to establish the effectiveness or indications of Stretta for patients with GERD and laryngopharyngeal symptoms. Future prospective controlled studies should focus on patients with objectively confirmed LPRD using ambulatory pharyngeal pH-impedance monitoring.