电子胃镜诊断食管憩室临床特点分析
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摘要
目的探究电子胃镜对食管憩室的检出情况及临床特点。方法回顾性分析2012年1月至2018年10月在宁夏回族自治区人民医院消化内镜中心行电子胃镜诊断的155例食管憩室患者的资料,包括患者年龄、性别、憩室部位、数量、伴发症。结果在行电子胃镜检查48 850例患者中,食管憩室患病率及检出率均为0.3%,其中单发憩室占97.45%,多发憩室占2.55%,其中无症状憩室占比达89.03%;在食管憩室的伴发病,慢性胃炎和消化性溃疡以61～70岁最常见,发病率依次为慢性胃炎(94.2%)、消化性溃疡(9.7%),反流性食管炎发病率仅为7.1%;在不同部位食管憩室伴胃食管反流病中,膈上部憩室伴发胃食管反流病的发生率最高达45.45%(5/11),其次分别为食管中段36.36%(4/11)、咽食管部18.18%(2/11),且不同部位食管憩室与胃食管反流病差异有统计学意义(χ~2=47.50,P<0.05);胃镜下表现为真菌性食管炎4例(2.6%),早期中段食管癌1例(0.6%)。结论电子胃镜对食管憩室有诊断价值,值得临床医师采用。
Objective To explore the detection and clinical characteristics of esophagus diverticulum by electronic gastroscopy.Methods The data of 155 patients with esophageal diverticulum diagnosed by electronic gastroscopy from January 2012 to October 2018 in Digestive Endoscopy Center of Ningxia Hui Autonomous Region People′s Hospital were retrospectively analyzed,including age,sex,diverticulum location,number and complications.Results In the 48 850 patients undergoing electronic gastroscopy,both the prevalence and detection rate of esophageal diverticulum were 0.3%,of which 97.45% were single diverticulum,2.55% were multiple diverticulum,and the proportion of asymptomatic diverticulum was 89.03%.In the incidence of esophageal diverticulum,chronic gastritis and peptic ulcer were most common in 61 to 70 years old,and the incidence rates were 94.2% and 9.7% respectively.The incidence rate of reflux esophagitis was only 7.1%.In different parts of the esophageal diverticulum with gastroesophageal reflux disease,the incidence rate of gastroesophageal reflux disease in the upper diaphragmatic diverticulum was up to 45.45%(5/11),followed by the middle esophagus 36.36%(4/11)and pharyngoesophagus 18.18%(2/11),with statistically significant difference(χ~2=47.50,P<0.05).gastroscopic presentation of fungal esophagitis was in 4 cases(2.6%)and early middle esophageal cancer in 1 case(0.6%).Conclusion Electronic gastroscopy has diagnostic value for esophageal diverticulum,and it is worthy of clinical application.
Objective To explore the detection and clinical characteristics of esophagus diverticulum by electronic gastroscopy.Methods The data of 155 patients with esophageal diverticulum diagnosed by electronic gastroscopy from January 2012 to October 2018 in Digestive Endoscopy Center of Ningxia Hui Autonomous Region People′s Hospital were retrospectively analyzed,including age,sex,diverticulum location,number and complications.Results In the 48 850 patients undergoing electronic gastroscopy,both the prevalence and detection rate of esophageal diverticulum were 0.3%,of which 97.45% were single diverticulum,2.55% were multiple diverticulum,and the proportion of asymptomatic diverticulum was 89.03%.In the incidence of esophageal diverticulum,chronic gastritis and peptic ulcer were most common in 61 to 70 years old,and the incidence rates were 94.2% and 9.7% respectively.The incidence rate of reflux esophagitis was only 7.1%.In different parts of the esophageal diverticulum with gastroesophageal reflux disease,the incidence rate of gastroesophageal reflux disease in the upper diaphragmatic diverticulum was up to 45.45%(5/11),followed by the middle esophagus 36.36%(4/11)and pharyngoesophagus 18.18%(2/11),with statistically significant difference(χ~2=47.50,P<0.05).gastroscopic presentation of fungal esophagitis was in 4 cases(2.6%)and early middle esophageal cancer in 1 case(0.6%).Conclusion Electronic gastroscopy has diagnostic value for esophageal diverticulum,and it is worthy of clinical application.
引文
1 Fiorelli A,Izzo AC,Arrigo E,et al.Resection of esophageal diverticulum through uniportal video-assisted thoracoscopic surgery[J]Ann Transl Med,2018,6(10):179.
2 张新波,周巧丽,王鹏鲲,等.食管憩室的诊断与外科治疗[J].中国综合临床,2013,29(6):628-629.
3 Herbella FAM,Dubecz A,Patti MG,et al.Esophageal diverticula and cancer[J].Dis Esophagus,2012,25(2):153-158.
4 Sato H,Takeuchi M,Hashimoto S,et al.Esophageal diverticulum:New perspectives in the era of minimally invasive endoscopic treatment[J]World J Gastroenterol,2019,25(12):1457-1464.
5 Allaix ME,Borraez Segura BA,Herbella FA,et al.Is resection of an esophageal epiphrenic diverticulum always necessary in the setting of achalasia?[J].World J Surg,2015,39(1):203-207.
6 Mecklenburg I,Weber C.Spontaneous recovery of dysphagia by rupture of an esophageal diverticulum in eosinophilic esophagitis[J].Digestive diseases and sciences,2006,51(7):1241-1242.
7 Lim SK.A Large Epiphrenic Esophageal Diverticulum Communicating with the Left Lower Lobe[J].Korean J Thoracic Cardiovascular Surgery,2019,52(1):4043.
8 Matthews BD,Nelms CD,Lohr CE,et al.Minimally invasive management of epiphrenic esophageal diverticula[J].Am Surg,2003,69(6):465-470.
9 周亚兰,魏旭东,米瑞华,等.13例恶性血液病并发真菌性食管炎患者的临床分析[J].中华血液学杂志,2016,37(6):507-511.
10 Asayama N,Nagata N,Shimbo T,et al.Relationship between clinical factors and severity of esophageal candidiasis according to Kodsi′s classification[J].Dis Esophagus,2014,27(3):214-219.
11 费贵军,吴东,吴晰,等.食管溃疡274例病因分析[J].中国实用内科杂志,2018,38(8):742-745.
12 胡柳丹,杨林,郭洁,等.150例食管溃疡的病因分析及内镜特征[J].临床消化病杂志,2018,30(3):150-152.
13 Rantanen TK,Sihvo EI,Rásánen JV,et al.Esophageal ulcer as a cause of death:a population-based study.mortality of esophageal ulcer disease[J].Digestion,2015,91(4):272-276
14 田永刚,曹贞子,白飞虎.不同病因所致食管溃疡临床特征的研究进展[J/CD].中华胃食管反流病电子杂志,2018,5(4):189-192.
15 徐蓓莉,蔡瑜,王剑,等.以食管溃疡为主要表现的系统性硬化症1例报告[J].中国临床医学,2018,25(4):673-675.
2 张新波,周巧丽,王鹏鲲,等.食管憩室的诊断与外科治疗[J].中国综合临床,2013,29(6):628-629.
3 Herbella FAM,Dubecz A,Patti MG,et al.Esophageal diverticula and cancer[J].Dis Esophagus,2012,25(2):153-158.
4 Sato H,Takeuchi M,Hashimoto S,et al.Esophageal diverticulum:New perspectives in the era of minimally invasive endoscopic treatment[J]World J Gastroenterol,2019,25(12):1457-1464.
5 Allaix ME,Borraez Segura BA,Herbella FA,et al.Is resection of an esophageal epiphrenic diverticulum always necessary in the setting of achalasia?[J].World J Surg,2015,39(1):203-207.
6 Mecklenburg I,Weber C.Spontaneous recovery of dysphagia by rupture of an esophageal diverticulum in eosinophilic esophagitis[J].Digestive diseases and sciences,2006,51(7):1241-1242.
7 Lim SK.A Large Epiphrenic Esophageal Diverticulum Communicating with the Left Lower Lobe[J].Korean J Thoracic Cardiovascular Surgery,2019,52(1):4043.
8 Matthews BD,Nelms CD,Lohr CE,et al.Minimally invasive management of epiphrenic esophageal diverticula[J].Am Surg,2003,69(6):465-470.
9 周亚兰,魏旭东,米瑞华,等.13例恶性血液病并发真菌性食管炎患者的临床分析[J].中华血液学杂志,2016,37(6):507-511.
10 Asayama N,Nagata N,Shimbo T,et al.Relationship between clinical factors and severity of esophageal candidiasis according to Kodsi′s classification[J].Dis Esophagus,2014,27(3):214-219.
11 费贵军,吴东,吴晰,等.食管溃疡274例病因分析[J].中国实用内科杂志,2018,38(8):742-745.
12 胡柳丹,杨林,郭洁,等.150例食管溃疡的病因分析及内镜特征[J].临床消化病杂志,2018,30(3):150-152.
13 Rantanen TK,Sihvo EI,Rásánen JV,et al.Esophageal ulcer as a cause of death:a population-based study.mortality of esophageal ulcer disease[J].Digestion,2015,91(4):272-276
14 田永刚,曹贞子,白飞虎.不同病因所致食管溃疡临床特征的研究进展[J/CD].中华胃食管反流病电子杂志,2018,5(4):189-192.
15 徐蓓莉,蔡瑜,王剑,等.以食管溃疡为主要表现的系统性硬化症1例报告[J].中国临床医学,2018,25(4):673-675.