摘要
目的探讨内镜下均一胃黏膜颗粒样改变的临床及病理特点,分析各种药物的治疗效果。方法通过对比胃黏膜颗粒样改变与普通慢性非萎缩性胃炎的临床表现、病理表现、H.pylori感染率、胆汁反流内镜检出率等分析胃黏膜颗粒样改变的临床特点。127例接受过内镜检查的胃黏膜颗粒样改变患者按治疗方式的不同分为三组,分别采用单纯质子泵抑制剂、质子泵抑制剂为主的四联根除H.pylori、质子泵抑制剂加抗胆汁反流药物治疗,并比较各组治疗效果。结果胃黏膜颗粒样改变组患者上腹痛、反酸烧心、纳差等症状发生率显著高于对照组(P<0.05),病理表现中肠上皮化生发生率、淋巴细胞浸润发生率显著高于对照组(P<0.05),H.pylori感染率显著高于对照组(P<0.05),胆汁反流发生率显著高于对照组(P<0.05)。41例胃黏膜颗粒样改变患者经质子泵抑制剂为主的四联根除H.pylori治疗10 d后继续质子泵抑制剂治疗3周,27例患者临床症状消失,8周后复查胃镜发现17例原黏膜隆起病变显著减轻或消失。42例患者经单纯质子泵抑制剂治疗4周后14例症状消失,8周后复查胃镜仅6例黏膜隆起病变显著减轻或消失。44例患者经质子泵抑制剂联合抗胆汁反流药物治疗4周后23例症状消失,8周后复查胃镜11例黏膜隆起病变显著减轻或消失。结论胃黏膜颗粒样改变作为一种特殊类型的胃炎,临床表现具有一定的特征性,根据H.pylori感染情况行根治H.pylori治疗联合抗胆汁反流治疗是该病有效的治疗方法,值得临床推广。
Objective To investigate the clinical and pathologic characteristics of gastric mucosal nodular changes and analyze the merits of treatments for optimizing the measures for the disease. Methods Clinical manifestation, pathological manifestation, H. pylori infection rate, bile reflux endoscopic detection rate were compared between gastric mucosal nodular changes and common chronic atrophic gastritis. Clinical characteristics of gastric mucosal nodular changes were analyzed. One hundred and twenty-seven cases of gastric mucosal nodular changes who underwent endoscopic examination were divided into three groups according to the treatment methods. Pure proton pump inhibitors, quadruple eradication H. pylori, proton pump inhibitors with bile reflux medication were used in patients with gastric mucosal nodular changes, and the treatment effect was compared. Results The incidence rates of abdominal pain, distention, heartburn in gastric mucosal nodular changes group were higher than those in control group （P 〈 0.05）. The incidence rate of intestinal metaplastia in the pathological results in 127 cases of gastric mucosal nodular changes was significant different than that in control group （P 〈 0.05）. The incidence rate of bile regurgitation was higher than that in control group （ P 〈 0.05）. Conclusion As a special gastritis, the patients with gastric mucosal nodular changes have particular clinical symptoms. The eradication of H. pylori is a very outstanding method to treat the disease.
出处
《胃肠病学和肝病学杂志》
CAS
2017年第5期548-550,共3页
Chinese Journal of Gastroenterology and Hepatology
关键词
胃黏膜颗粒样改变
内镜
质子泵抑制剂
幽门螺杆菌
Gastric mucosal nodular changes
Endoscopy
Proton pump inhibitors
Helieobacter pylori
