食管上段胃黏膜异位内镜下合并症的研究
作者:
作者单位:

1.遵义医科大学,贵州 遵义 563000;2.遂宁市中心医院 消化中心,四川 遂宁 629000

作者简介:

] 熊鑫,现在遵义医科大学攻读硕士研究生(专业学位),临床规培基地为遂宁市中心医院消化中心四病区

通讯作者:

何素玉,E-mail:hesuyu2009@163.com

基金项目:

四川省卫生健康科研课题普及项目(No:2019PJ282)


Study on complications of upper esophageal gastric mucosa under heterotopic endoscopy
Author:
Affiliation:

1.Zunyi Medical University, Zunyi, Guizhou 563000, China;2.Department of Digestive Center, Suining Central Hospital, Suining, Sichuan 629000, China

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    摘要:

    目的 研究食管上段胃黏膜异位(HGMUE)的内镜检出率、内镜下表现和合并症。方法 回顾性研究2019年1月-2020年6月该院消化内镜中心经电子食管胃镜检查且诊断为HGMUE的患者资料。分析HGMUE的检出率、内镜下表现和合并症。结果 51 326例接受胃镜检查的患者中,375例诊断为HGMUE,检出率为0.73%。内镜下主要表现为玫瑰色-橘红色的天鹅绒样斑块,与周围食管黏膜界限清楚,可有多个,且大小不一。内镜下合并症包括:内镜阳性的胃食管反流病75例(20.00%),其中反流性食管炎44例(11.73%)、Barrett食管26例(6.93%)、两者合并存在5例(1.13%);糜烂性胃炎56例(14.93%);息肉54例(14.40%),其中胃息肉47例(12.53%)、十二指肠球部息肉7例(1.87%);消化性溃疡42例(11.20%),其中十二指肠球部溃疡21例(5.60%)、胃溃疡17例(4.53%)、两者合并存在4例(1.07%);恶性肿瘤9例(2.40%),其中胃癌3例(0.80%)、食管癌6例(1.60%),无合并症的HGMUE 139例(37.06%)。结论 HGMUE合并酸相关性疾病较为常见;合并上消化道恶性肿瘤尤其是食管恶性肿瘤的占比较高,这可能是上消化道肿瘤的预警因子之一,应予以重视。

    Abstract:

    Objective To investigate the incidence of heterotopic gastric mucosa in upper esophagus (HGMUE), and study the endoscopic manifestation and comorbidity of HGMUE.Methods A retrospective study was made among patients who underwent esophago-gastroduo-denoscopy and diagnosed with HGMUE from January 2019 to June 2020.Results Of the 51 326 patients who underwent EGD, 375 were diagnosed with HGMUE (0.73%). HGMUE are a velvety mucosa that is rosiness-orange in color, well-circumscribed in area, variable in quantity and size. Endoscopic complications include: gastroesophageal reflux disease with positive endoscopic image (n = 75, 20.00%) which included reflux esophagitis (RE, n = 44, 11.73%), Barrett’s esophagus (BE, n = 26, 6.93%), RE and BE coexists (n = 5, 1.13%); Erosive gastritis (n = 56, 14.93%); Polyps (n = 54, 14.40%) which included gastric polyps (n = 47, 12.53%) and duodenal polyps (n = 7, 1.87%). The forth was peptic ulcer (n = 42, 11.20%) which included duodenal ulcer (DU, n = 21, 5.60%), gastric ulcer (GU, n = 17, 4.53%), GU and DU coexists (n = 4, 1.07%); Malignancy (n = 9, 2.40%) which included gastric carcinoma (n = 3, 0.80%) and esophageal carcinoma (n = 6, 1.60%). HGMUE without endoscopic complications (n = 139, 37.06%).Conclusion Acid related diseases were common comorbidities of HGMUE. Since a relatively high prevalence of malignancy, especially esophageal malignancy was found as comorbidity of HGMUE, it could be a warning factor for malignancy.

    图1 HGMUE不同胃镜下表现Fig.1 HGMUE manifestations under different gastroscopic techniques
    图2 HGMUE内镜下分型Fig.2 The endoscopic classification of HGMUE
    图3 HGMUE对吻型病变不同胃镜下表现Fig.3 Manifestations of kissing lesions in HGMUE under different gastroscopic techniques
    图4 HGMUE病理学表现Fig.4 The pathological manifestations of HGMUE
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熊鑫,何素玉,徐菲,曹丽鹏,荆晓娟,何莲芬,王寒梅,刘天宇,贾映东.食管上段胃黏膜异位内镜下合并症的研究[J].中国内镜杂志,2021,27(4):1-6

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  • 收稿日期:2020-09-29
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  • 在线发布日期: 2021-05-07
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