胃镜检查对“烧心”症状患者诊断价值的临床研究

Clinical studies of gastrointestinal endoscopy in diagnosis of patients with heartburn symptoms

摘要:

目的 探讨胃镜对“烧心”症状患者的临床诊断价值。方法 选取2011年10月~2013年10月在该院消化内科就诊，具有“烧心”症状且接受胃镜检查的患者共326例进行问卷调查，由专业人员进行记录分析。结果 326符合选入及排除标准的患者中，121例（37.12%）胃镜检查结果阳性，其中99例（30.37%）例被诊断为糜烂性食管炎，10例（3.07%）被诊断为Barrett食管，且5例同时合并患者有BE和EE,其余为消化性溃疡。经Logistic回归分析，年龄>50岁、男性、高龄、超重、吸烟以及饮酒史为阳性胃镜及糜烂性食管炎的独立危险因素，高龄的男性超重患者若合并吸烟史和饮酒史，胃镜结果更有意义且发生糜烂性食管的概率更高（P <0.05），而“烧心”频率程度及病程与胃镜结果及糜烂性食管炎的发病无关（P >0.05）。结论 有“烧心”症状者应及时进行胃镜检查以排除肿瘤及消化性溃疡等，并应同时合并进行24 h pH值监测以及食管滴酸实验合并诊断，保证疾病的早期诊断。

Abstract:

【Objective】 To evaluate the diagnostic value of endoscopic profile in adult population with heartburn symptoms. 【Methods】 A total of 326 cases patients with heartburn symptoms and underwent gastroenterology were studied in our hospital between October 2011 and October 2013. The patients were investigated through questionnaires, logical analysis by professionals. 【Results】 A total of 326 patients were complied with opt-in and exclusion criteria. The number of 121 cases (37.12%) had endoscopy positive results. The patients of 99 cases (30.37%) were diagnosed as erosive esophagitis, and 10 cases (3.07%) were diagnosed with Barrett's esophagus. The rest were peptic ulcer. Through logistic regression analysis, age (>50 years), male gender, overweight and smoking, drinking history were independent risk factors for positive endoscopy and erosive esophagitis. The old overweight male patients combined with a history of smoking and drinking had higher probability in endoscopy results and occurrence of erosive esophagitis (P <0.05). The extent and the frequency of heartburn were unrelated with endoscopic findings and the incidence of erosive esophagitis. 【Conclusion】 Patients with heartburn symptoms should be promptly endoscopy to rule out cancer, peptic ulcer. At the same time, they should be carried out 24 hours pH monitoring and esophageal acid droplets in order to ensure early diagnosis of the disease.