Barrett食管内镜临床诊断及病理的的特点分析.docVIP

Barrett食管内镜临床诊断及病理的的特点分析 　　[摘要] 目的 分析Barrett食管的临床症状、镜下表现及病理特点。方法 回顾分析我院2007年10月～2009年10月间由胃镜及镜下活检病理学检查证实Barrett食管患者330例,分析其临床资料和胃镜表现。结果 患者中男210例,女120例;以反酸(225例,68.2%)、烧心(204例,61.8%)及胸骨后痛(103例,31.2%)等为主要临床症状。镜下形态以岛型为主(280例,占84.8%),病变长度0.5~5.5cm,其中115例患者(34.8%)伴有食管裂孔疝。食管压力检查提示屏障压及食管中下段压力明显降低,酸反流总时间、总次数以及酸清除时间均明显增加。结论 Barrett食管的临床症状与胃食管反流病无明显差别,是胃食管反流病的严重并发症;抑酸联合内镜下治疗为其提供了新的治疗方法。 　　[关键词] Barrett食管; 胃镜检查; 病理分析 　　[中图分类号] R571 [文献标识码] A [文章编号] 1673-9701(2010)15-25-02 　　 　　Clinical and Pathological Features of Barrett Esophagus 　　HE Min YANG Lili 　　Gastroenterology,Peking University Shenzhen Hospital,Shenzhen 518036,China 　　 　　[Abstract] ObjectiveTo analyze the clinical symptoms and endoscopic and pathological features of Barrett esophagus. MethodsA retrospective analysis was made of the clinical data and endoscopic manifestations of 330 cases of Barrett esophagus confirmed by using endoscope and endoscopic biopsy and pathological examination in our hospital from Oct. 2007 to Oct. 2009. ResultsIn 330 cases,210 males and 120 females,acid reflux accounted for 225 cases,68.2%,heartburn 204 cases,61.8% and retrosternal pain 103 cases,31.2% as the main clinical symptoms. An island-based microscopy accounted for 280 cases,84.8%,with the lesion length of 0.5 ~ 5.5cm,in which 115 cases(34.8%)were associated with esophageal hiatal hernia. Esophageal barrier pressure examinations showed the lower esophageal pressure was significantly lowered,while acid reflux total time,total number and acid clearance time were significantly increased. ConclusionThere was no significant difference in the symptoms between Barrett esophagus and gastroesophageal reflux disease,with the former as a serious complication of the latter. Acid suppression combined with endoscopic therapy is a new treatment for Barrett esophagus. 　　[Key words]Barrett esophagus; Endoscope; Pathology analysis 　　 　　Barrett食管(Barrett esophagus,BE)是指食管下段的复层鳞状上皮被特殊柱状上皮所替代的一种病理现象,具有BE病例特性最大的风险就是癌变。其发生食管癌的危险性较一般人群高30～50倍