胃食管喉气管反流及其综合症

胃食管反流病（Gastreoesophageal reflux disease，GERD）即胃十二指肠内容物反流入食管，引起反酸、烧心、反食、嗳气等症状，它可导致食组织损害。咽喉反流（laryngopharygeal reflux。LPR）为胃内容物反流至咽喉部，引起慢性咽喉炎、声音嘶哑、咽异物感、频繁清嗓、慢性咳嗽、吞咽困难等临床表现。胃食管喉气管反流（gastroesophago-larygotracheal reflux，GELTR）则是发自贲门部的，以咽喉部为反应中心的，常以气道表现尤其是哮喘、喉气道激惹为突出点的，涉及呼吸和消化两大系统和耳鼻口腔的反流性疾病，它引起一系列相应临床表现（但偏偏可以没有烧心和反酸），也就是以胃食管交接处为启动器、以咽为反应器、以口鼻为效应器，以喉气道为喘息发生器的一种临床症候群，即胃食管喉气管综合徵（gastroesophago—larygotracheal syndrome，GELTS）．许多有严重“哮喘”、喉部发紧、重症咳嗽、咯痰和声音嘶哑、听力障碍等常见和多发病患者，一旦得到正确诊断，很可能得到希望和新生。本文旨在以罕有的食管和气道共充钡的图像等为依据，从咽喉反流开始进行探讨胃食管反流病。

Gastroesophago-larygotracheal reflux and its syndrome

Gastroesophageal reflux disease is a disorder, caused by regurgitating of the duodenal and gastric contents into the esophagus, which leads acid regurgitation, heartburn, eructation, and injury of the esophageal, tissues. Laryngopharygeal reflux is the same contents regurgitate to throat, which brings about chronic pharyngolaryngitis, hoarseness, foreign bodies sensation, throat clearing, chronic cough and dysphagia. Gastroesophago-larygotracheal reflux is a syndrome, initiating in the cardia and reacting in the laryngopharyx and involving both the respiratory and digestive system, and ear, nose, and oral cavity. It presents mainly characteristics of asthma and larynx-airway irritation, however it may particularly appear with neither heartburn nor acid regurgitation in some instances. The hypothesis of gastroesophago-laryngotracheal syndrome （GELTS） was rasied with the gastroesophageal junction as the generator, the pharynx as the reactor, the oro-rhinol cavity as effector, the larynx and respiratory tract as asthmatic producer. When the patients who are suffering from severe asthma, throat tightness, severe cough, expectoration, hoarseness and dysaudia due to that syndrome, once a correct diagnosis is made, an improvement or even a new life might be very likely to bring about since the effecrive means is available. Therefore we provide unique figure showing the barium filling into the esophagus and bilateral lower airway and other evidence to explore this concept beginning from the larygopharynx reflux.