摘要
目的 分析不同组织学类型胃息肉的临床特点.方法 根据组织学不同,将胃息肉分为胃底腺息肉、增生性息肉、炎性息肉、腺瘤性息肉等,比较各型胃息肉在发病部位、幽门螺杆菌（Hp）感染、质子泵抑制剂（PPI）与胃息肉发生的关系等方面的异同,从而指导治疗.结果 10 197例接受胃镜检查的患者中检出胃息肉365例,检出率为3.6%.胃息肉的组织学类型依次为胃底腺息肉（61.1%）,增生性息肉（23.3%）,炎性息肉（12.3%）,腺瘤性息肉（2.2%）.289例（79.2%）为单发性息肉,各型胃息肉均以单发为主.胃息肉主要分布在胃体和底部,其次是胃窦和贲门.胃底腺息肉绝大多数分布在胃体和底部;增生性和腺瘤性息肉以胃窦部为主;炎性息肉以贲门、胃体和底部为主.胃底腺息肉患者应用PPI的比例较高（51.6%）,与增生性息肉（8.2%）和炎性息肉（8.9%）患者比较,差异均有统计学意义（x2值分别为48.31、27.63,P均〈0.01）.增生性和炎性息肉的Hp感染率分别为72.4%和74.4%,均高于胃底腺息肉（20.2%）（X2值分别为46.50、35.04,P均〈0.01）.根除Hp后1年随诊,增生性息肉和炎性息肉再发病例明显降低[2.4%（1/41）和0（0/19）].结论 胃息肉的组织学类型以胃底腺息肉为最常见,其次为增生性息肉.胃息肉主要分布在胃体和底部,其次是胃窦和贲门.不同类型胃息肉在胃内的分布有一定的特点.长期应用PPI有发生胃底腺息肉的风险.增生性息肉和炎性息内的发生可能与Hp感染有关,根除Hp后可能有助于预防这两型胃息肉的再发.
Objective To analyze the clinical characteristics of gastric polyps in different histopathological types. Methods Based on histopathological difference, gastric polyps were categorized into fundic gland polyps, hyperplastic polyps, inflammatory polyps, adenomatous polyps, etc; Different types of polyps in the aspects of distribution, Helicobacter pylori （H. pylori） infection, the relationship between the proton pump inhibitors （PPI） and the occurrence of gastric polyps to provide guidance on treatment Results 365 cases of gastric polyps were diagnosed in 10 197 patients who underwent gastroscopy. The prevalence was 3. 6%. The histopathological type of the polyps were fundic gland polyps （61. 1%）, hyperplastic polyps （23. 3%） , inflammatory polyps （12. 3%） , adenomatous polyps （2. 2%）. 289 cases showed single polyps, which was the majoriry across all types of gastric polyps. Majority of the gastric polyps were located in gastric body and fundus, followed by gastric antrum and cardia Most of the fundic gland polyps were located in gastric body and fundus; Majority of the hyperplastic polyps and adenomatous polyps were located in gastric antrum; The main locations of inflammatory polyps were cardia and gastric body and fundus. A higher percent （51. 6%） of fundic gland polyps patients used PPI. The difference was statistically significant compared with the hyperplastic polyps（8. 2%）and inflammatory polyps group（8.9%） （x2 = 48. 31,27. 63 ,P 〈0. 01）. The H. pylori infection rate of hyperplastic polyps and inflammatory polyps were 72.4% and 74.4% ,respectively, both of which were higher than that of fundic gland polyps（20. 2%）（x2 =46. 50,35. 04, P 〈 0. 01） . One year after the H. pylori eradication, the recurrence cases of hyperplastic polyps and inflammatory polyps were 1/41 and 0/19,respectively. Conclusions The main histopathological type of gastric polyps is fundic gland polyps followed by hyperplastic polyps. The main location of the gastric polyps is gastric body
出处
《中国综合临床》
2010年第6期581-584,共4页
Clinical Medicine of China
关键词
胃息肉
幽门螺杆菌
质子泵抑制剂
组织学类型
Gastric polyp
Helicobacter pylori
Proton pump inhibitor
Histopathological type
