665例胆汁返流性胃炎临床分析.docVIP

精品论文 参考文献 665例胆汁返流性胃炎临床分析 许宜坚 　　（德保县人民医院消化内科 广西百色 533700） 　　【摘要】目的 探讨胆汁返流性胃炎（BRG）的病因、发病机制及与HP感染、病理组织学改变的关系。方法：对我院665例诊断为BRG患者进行电子胃镜检查、HP感染检测、病理组织学检查。结果：胃镜检查结果：一度胆汁返流201例（30.23%）；二度胆汁返流271例（40.75%）；三度胆汁返流193例（29.02%）；年龄在21～60岁患者513例（77.14%），其中大部分是二度以上中重度胆汁返流464例（占69.77%）。合并症占前三位的是：反流性食管炎191例（28.72%）、十二指肠球部溃疡189例（28.42%）、十二指肠炎症77例（11.58%）。幽门螺杆菌阳性139例，阳性率为20.90%。病理结果：慢性浅表性炎症改变507例（76.24%），慢性萎缩性炎症改变158例（23.76%）、其中中、重度萎缩80例、胆汁返流程度均二度以上。123例肠上皮化生患者中，二度以上胆汁返流104例（占84.55%）；97例非典型增生患者中，38例中、重度非典型增生患者胆汁返流程度均二度以上。结论：胆汁返流性胃炎青壮年多发，容易合并十二指肠球部溃疡、反流性食管炎；胆汁返流程度越重，越容易出现中重度萎缩性胃炎、肠上皮化生、中重度非典型增生，因此胆汁返流应给予高度重视、积极干预。 　　【关键词】 胆汁返流 胃炎 胃镜检查 　　【中图分类号】R573.3 【文献标识码】A 【文章编号】2095-1752（2014）20-0055-02 　　Clinical analysis of 665 patients of bile reflux gastritis 　　Xu Yi jian 　　Department of internal medicine Debao people,s Hospital digestion of Guangxi Baise Debao 533700 　　【Abstract】Objective To investigate the etiology, pathogenesis, and pathological changes of bile reflux gastritis （BRG）and the relationship with HP infection. Methods: 665 patients in our hospital with electronic gastroscopy were diagnosed as BRG. In the meantime, HP infection detection, pathological examination were performed. Results: gastroscopy displayed one degree of bile regurgitation in 201 patients (30.23%), two degree of bile regurgitation in 271 patients(40.75%), three degree of bile regurgitation in 193 patients (29.02%). 513 patients (77.14%) are21～60 years old, in with, 464 patients (69.77%) are two or more degree of bile regurgitation inelectronic gastroscopy. The top three complication as follow: 189 patients (28.42%) complicated with duodenal ulcer, 191 patients (28.72%) with reflux esophagitis, and 77 patients(11.58%) withduodenal inflammation. 139 patients (20.90%) with Helicobacter pylori positive, the positive rate was （20.90%). 507 patients (76.24%) with Chronic superficial inflammation, 158 patients(23.76%) with Chronic atrophic inflammation,