摘要
目的探讨特殊类型食管溃疡患者的临床特点及影响预后的因素。方法回顾性分析2014年10月至2019年10月间就诊于本院的53例特殊类型食管溃疡患者的病例资料,并电话随访预后。结果53例患者男女比例1.52∶1,发病年龄(51.2±13.4)岁,84.91%(45/53)患者原因不明,66.67%(34/51)有胸骨后、上腹部疼痛或不适的表现,67.92%(36/53)溃疡累及食管下段,52.83%(28/53)累及食管胸中段。常见的病理改变为慢性炎症和鳞状上皮增生,有24.53%(13/53)患者治疗后无好转、恶化或者治疗后复发。结核感染T细胞斑点试验(TSPOT)阳性且合并有其他一项结核感染依据的全部7例患者抗结核治疗有效。结论特殊类型食管溃疡常见于中年男性,大多数患者病因不明。食管走行区域的不适及疼痛是最常见的临床症状,常见的累及部位为食管下段,疗效欠佳或易复发。抗结核治疗对TSPOT阳性且合并有其他一项结核感染依据的患者可能有效。
Objective To explore the clinical characteristics and prognostic factors of patients with special types of esophageal ulcer.Methods The data of 53 cases of esophageal ulcer in Xiangya Hospital of Central South University from October 2014 to October 2019 were analyzed retrospectively,and the prognosis was followed up by telephone.Results The average age of onset was(51.2±13.4)years old.84.91%of the patients(45/53)had unknown causes.66.67%(34/51)had symptoms of discomfort or pain in the esophageal region.67.92%(36/53)of the ulcers involved the lower esophageal segment and 52.83%(28/53)involved the middle thoracic segment of the esophagus.The common pathological changes were chronic inflammation and squamous cell hyperplasia.Nearly 1/3 of the patients had no improvement,deterioration or recurrence after treatment.All 7 patients with T cell spot test of tuberculosis infection(TSPOT)positive and other tuberculosis infection were treated effectively.Conclusions Special types of esophageal ulcer are common in middle-aged men,most of the patients have unknown etiology.The most common clinical symptom is the discomfort or pain in the area of esophagus.The common involved part is the lower part of esophagus.The curative effect is not good or easy to recur.Antituberculosis therapy may be effective in patients with TSPOT positive and other TB infection bases.
作者
张彦秋
文珍
吴蓉
陈彬
彭雪梅
冷爱民
Zhang Yanqiu;Wen Zhen;Wu Rong;Chen Bin;Peng Xuemei;Leng Aimin(Department of Gastroenterology,Xiangya Hospital,Central South University,Changsha 410008,China C)
出处
《中国医师杂志》
CAS
2020年第4期544-548,554,共6页
Journal of Chinese Physician
