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[目的]分析胃黏膜肠化生的临床特征。[方法]对3 318例胃镜及病理检查证实的肠化生患者资料进行回顾性分析、总结。[结果]肠化生多发生于50~70岁年龄;男性多于女性;胃内分布:贲门及胃底部占13.3%、胃体大弯侧8.7%、胃体小弯侧27.6%、胃体前壁10.5%、胃体后壁9.1%、胃窦30.8%;轻、中、重度肠化所占比例分别为76.8%、18.0%、5.3%;病理检查肠化生常伴有萎缩及非典型增生,其中单纯肠化病变占32.8%,伴有萎缩的占64.9%,伴有非典型增生的占5.8%;内镜描述常为黏膜发红、糜烂、溃疡、痘疹样隆起,所占比例分别为38.8%、32.3%、12.7%、18.7%。肠化生患者幽门螺杆菌检出率82.67%,高于非肠化生患者(P<0.05);临床症状有不同程度重叠,上腹不适占16.9%、上腹痛18.9%、反酸烧心8.7%、腹胀14.9%、食欲不振13.9%,其他37.4%。[结论]肠化生多发生于中老年人,临床症状无明显特异性,严格的内镜评估以及病理活检对提高肠化生的诊断率尤为重要。
[Objective] To analyze the clinical features of gastric metaplasia metaplasia. [Methods] A retrospective analysis and summary of 3 318 cases of intestinal metaplasia confirmed by endoscopy and pathology were performed. [Results] Intestinal metaplasia mostly occurred in the age of 50 ~ 70 years. There were more males than females. The distribution in the stomach was 13.3% at the cardia and fundus, 8.7% at the greater curvature of the corpus, 27.6% of the lesser curvature of the corpus, 10.5% of anterior body wall, 9.1% of gastric wall and 30.8% of gastric antrum. The rates of mild, moderate and severe intestinal metaplasia were 76.8%, 18.0% and 5.3% respectively. Pathological examination of intestinal metaplasia often accompanied by atrophy and SARS Type hyperplasia, including intestinal metaplasia accounted for 32.8%, with atrophy accounted for 64.9%, with atypical hyperplasia accounted for 5.8%; endoscopic description often mucosal redness, erosion, ulcers, measles-like uplift, accounting for The proportions were 38.8%, 32.3%, 12.7% and 18.7% respectively. The detection rate of Helicobacter pylori in intestinal metaplasia patients was 82.67%, higher than that in non-intestinal metaplasia patients (P <0.05). Clinical symptoms were overlapped in varying degrees, with upper abdominal discomfort 16.9%, upper abdominal pain 18.9%, acid reflux heartburn 8.7% , Abdominal distension 14.9%, loss of appetite 13.9%, other 37.4%. [Conclusion] Intestinal metaplasia mostly occurs in middle-aged and elderly people, and there is no obvious clinical symptoms. The strict endoscopy and pathological biopsy are especially important to improve the diagnosis rate of intestinal metaplasia.