复发性反流性食管炎内镜特征的临床对比研究

Clinical comparative study of endoscopic features of recurrent reflux esophagitis

摘要:

目的 探讨以症状复诊的反流性食管炎患者的内镜特征。方法 收集2007年1月至2017年12月在山东省聊城市人民医院前后两次行内镜检查，且间隔时间≥3年的反流性食管炎患者资料，对患者反流性食管炎黏膜破损发生部位、洛杉矶分级、胃食管阀瓣分级进行回顾性分析。结果 本研究共纳入192例患者，反流性食管炎黏膜破损发生在左前壁的患者有53例，左后壁的有47例，右后壁的有108例，右前壁的有179例。在192例患者中，前后两次内镜检查均提示存在反流性食管炎的患者共150例，两次内镜检查间隔时间为（4.67±1.63）年，前后两次黏膜破损发生部位、洛杉矶分级、胃食管阀瓣分级比较差异均无统计学意义（P>0.05），对前后两次内镜检查洛杉矶分级赋分后进行配对t检验，结果示差异无统计学意义[（1.77±0.85）分比（1.73±0.87）分，t=0.529，P=0.598]。结论 反流性食管炎黏膜破损最易发生于右前壁，且容易在相同部位复发。反流性食管炎复发患者洛杉矶分级、胃食管阀瓣分级均表现为与初次发病时的相同等级。

Abstract:

objective To explore the endoscopic features of patients with reflux esophagitis who have been diagnosed with symptoms.Methods The reserch collected the patients who had twice endoscopic examination of upper digestive tract less than three years of Liaocheng People’s Hospital between January 1, 2017 to December 31, 2017. Retrospective analysis of mucosal lesions in patients with reflux esophagitis, LA classification, and gastroesophageal grading.Results This study contains a total of 192 patients, there were 53 patients with reflux esophagitis in the left anterior wall, 47 patients in the left posterior wall, 108 patients in the right posterior wall, and 179 patients in the right anterior wall. In 192 patients,150 cases of patients with recurrence of RE, the average interval of recurrence in patients with reflux esophagitis two endoscopic examination of (4.67+1.631) years,the results showed that there were no statistically significant differences between the two sites of mucosal damage, Los Angeles classification and gastroesophageal valve grading. (P> 0.05).Conclusion The mucosal damage of reflux esophagitis is most likely to occur in the right anterior wall, and mucosal damage in patients with reflux esophagitis is likely to occur again in the same site. In patients with recurrent esophagitis recurrence, the classification of Los Angeles and the classification of gastroesophageal valve flap It is expressed at the same level as the first occurrence of reflux esophagitis.