摘要
目的探讨老年人反流性食管炎(RE)的临床和内镜特点。方法将2067例RE分为老年组(1119例)和非老年组(948例),并对其临床和内镜资料进行对比分析。结果老年组和非老年组RE检出率分别为8.9%和4.3%(P<0.01);呕血或/和黑便的发生率分别为14.6%和6.9%(P<0.05);其他临床表现两组相似。老年组内镜下分级为Ⅰ级62.4%、Ⅱ级24.7%、Ⅲ级11.6%和Ⅳ级1.3%,非老年组分别为74.5%、21.1%、4.1%和0.3%,两组构成趋势一致,但老年组Ⅲ级+Ⅳ级所占的比率显著高于非老年组,分别为13.0%和4.4%(P<0.01);老年组伴发食管裂孔疝和残胃者分别为32.4%和9.8%,非老年组分别为11.9%和4.2%(均为P<0.05);老年组合并的Barrett食管伴异型增生者占33.8%(24/71)、癌变者占4.2%(3/71),非老年组分别为11.8%(9/76)和0%(均为P<0.05)。结论RE是老年人常见病,检出率是非老年人的2倍;老年人RE伴发食管裂孔疝和残胃者较多,内镜下病变较重,伴出血者较多;老年人RE合并的Barrett食管更易发生异型增生和癌变。
Objective To explore clinical and endoscopic features of reflux esophagitis（RE） in the elderly. Methods Two thousand and sixty-seven cases with RE were divided into elderly group （n= 1119） and nonelderly group （n 948） according to age. The detection rate, clinical and endoscopic findings, accompanied illness of the two groups were analyzed. Results The detection rate of RE was 8.9％ in the elderly, and 4.3％ in the non elderly （P〈0.01）. The incidence of haematemesis or/and melaena was 14.6％ in the elderly and 6.9％ in the non elderly （P〈0.05）. The other clinical manifestations were similar between the two groups. The endoscopic grade （Savary Miller） were grade Ⅰ 62.4%, grade Ⅱ 24.7%, grade Ⅲ 11.6% ,grade Ⅳ 1.3% in the elderly,and 74.5% ,21.1%, 4.1%, 0.3% in the non- elderly, respectively. Grade Ⅲ plus grade Ⅳ in the elderly（13.0%） were more than in the non-elderly（4.4%, P〈0.01）. The RE cases with hiatal hernia and remnant stomach were 363 cases（32.4%） and 110 cases （9.8%） in the elderly, 113 cases（11.9%） and 40 cases （4.2%） in the non elderly, respectively （P〈0.05）. The biopsies showed 71 cases of Barrett esophagus, 24 cases hyperplasia （ 33.8%）, 3 cases adenocarcinoma （4.2 %） in the elderly, and 76 cases, 9 cases（ 11.8 %）, no adenocarcinoma in the non-elderly, respectively（all P〈0.05）. Conclusions The reflux esophagitis is common in the elderly, its detection rate is double non-elderly. The RE cases with hiatal hernia, remnant stomach or haemorrhage in the elderlywere more than in the non-elderly remarkably. The endoscopic changes in the elderly are more serious than in the non-elderly. It is possible that Barrett esophagus accompanied RE is easy to develop hyperplasia or adenocarcinoma in the elderly.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2005年第8期574-576,共3页
Chinese Journal of Geriatrics
关键词
老年人
反流性食管炎
内镜
诊断
Gastroesophageal reflux
Esophagitis, peptic
Endoscopy, digestive system
