目的观察十二指肠球部胃黏膜异位(heterotopic gastric mucosa in the duodenal bulb,HGMDB)的临床特点,探讨其治疗方法。方法分析、总结经内镜、病理检查等确诊为十二指肠球部胃黏膜异位患者的临床资料、内镜报告、病理报告等。结果共1...目的观察十二指肠球部胃黏膜异位(heterotopic gastric mucosa in the duodenal bulb,HGMDB)的临床特点,探讨其治疗方法。方法分析、总结经内镜、病理检查等确诊为十二指肠球部胃黏膜异位患者的临床资料、内镜报告、病理报告等。结果共14例患者。男7例,女7例;年龄26～73岁,平均48岁。病程1个月～10余年,患者均以反复上腹部疼痛为首发症状。胃镜下观察所有患者的幽门和十二指肠球部无变形,黏膜未见糜烂、溃疡;球部病变多位于前壁;分别呈扁平斑片状或鹅卵石样隆起、息肉样隆起、菜花样隆起等,表面光滑,色泽偏红、偏白或与附近球部黏膜相仿;靛胭脂染色腺管开口与十二指肠球部黏膜相似。病理检查与十二指肠球部黏膜固有层均可见胃底腺,有典型的含强嗜酸性颗粒的壁细胞和含嗜碱性颗粒的主细胞。使用H2受体拮抗剂(H2RA)或质子泵抑制剂(PPI)治疗可缓解症状;2例患者接受内镜下高频电烧灼术,1例症状明显改善,1例无效。结论HGMDB以中年发病多,性别无差异,常以上腹部疼痛为首发症状;胃镜检查的普及、内镜技术水平的提高及与其他铺助检查手段的联合应用有助于HGMDB的检出;H2RA和PPI等可有效缓解症状,内镜下高频电烧灼术等可能有助于HGMDB的治疗。展开更多
Duodenal ulcer (DU) can be developed viaseveral different mechanisms.Hypersecretion ofgastric acid is,however,a common denominator.Amassive hypersecretion of acid can by itself evoke aDU,e.g.in the Zollinger-Ellison s...Duodenal ulcer (DU) can be developed viaseveral different mechanisms.Hypersecretion ofgastric acid is,however,a common denominator.Amassive hypersecretion of acid can by itself evoke aDU,e.g.in the Zollinger-Ellison syndrome.Irrespective of the mechanism behind thedevelopment of a DU,powerful antisecretorytreatment will heal the ulcer and preventrecurrence.展开更多
Objective To study the mechanism of gastric metaplasia in duodenum through the transplantation of a flap of duodenal wall with vascular pedicle to the stomach. Methods The pediculated duodenal wall flaps of ...Objective To study the mechanism of gastric metaplasia in duodenum through the transplantation of a flap of duodenal wall with vascular pedicle to the stomach. Methods The pediculated duodenal wall flaps of Wistar rats were transplanted to their stomachs. The rats were killed at the 3rd, 6th, 9th and 12th month after the operation respectively, and histological changes of the duodenal grafts were observed with optical and electron microscopy. Results Gastric metaplasia was found in the mucosa of duodenal grafts transplanted to the stomach at the 6th, 9th and 12th month. Conclusions The formation of gastric metaplasia in the duodenal mucosa may be related to a change of the microenvironment around the tissues, and duodenal mucosa may differentiate into gastric epithelium by the decrease of pH value.展开更多
文摘目的观察十二指肠球部胃黏膜异位(heterotopic gastric mucosa in the duodenal bulb,HGMDB)的临床特点,探讨其治疗方法。方法分析、总结经内镜、病理检查等确诊为十二指肠球部胃黏膜异位患者的临床资料、内镜报告、病理报告等。结果共14例患者。男7例,女7例;年龄26～73岁,平均48岁。病程1个月～10余年,患者均以反复上腹部疼痛为首发症状。胃镜下观察所有患者的幽门和十二指肠球部无变形,黏膜未见糜烂、溃疡;球部病变多位于前壁;分别呈扁平斑片状或鹅卵石样隆起、息肉样隆起、菜花样隆起等,表面光滑,色泽偏红、偏白或与附近球部黏膜相仿;靛胭脂染色腺管开口与十二指肠球部黏膜相似。病理检查与十二指肠球部黏膜固有层均可见胃底腺,有典型的含强嗜酸性颗粒的壁细胞和含嗜碱性颗粒的主细胞。使用H2受体拮抗剂(H2RA)或质子泵抑制剂(PPI)治疗可缓解症状;2例患者接受内镜下高频电烧灼术,1例症状明显改善,1例无效。结论HGMDB以中年发病多,性别无差异,常以上腹部疼痛为首发症状;胃镜检查的普及、内镜技术水平的提高及与其他铺助检查手段的联合应用有助于HGMDB的检出;H2RA和PPI等可有效缓解症状,内镜下高频电烧灼术等可能有助于HGMDB的治疗。
文摘Duodenal ulcer (DU) can be developed viaseveral different mechanisms.Hypersecretion ofgastric acid is,however,a common denominator.Amassive hypersecretion of acid can by itself evoke aDU,e.g.in the Zollinger-Ellison syndrome.Irrespective of the mechanism behind thedevelopment of a DU,powerful antisecretorytreatment will heal the ulcer and preventrecurrence.
文摘Objective To study the mechanism of gastric metaplasia in duodenum through the transplantation of a flap of duodenal wall with vascular pedicle to the stomach. Methods The pediculated duodenal wall flaps of Wistar rats were transplanted to their stomachs. The rats were killed at the 3rd, 6th, 9th and 12th month after the operation respectively, and histological changes of the duodenal grafts were observed with optical and electron microscopy. Results Gastric metaplasia was found in the mucosa of duodenal grafts transplanted to the stomach at the 6th, 9th and 12th month. Conclusions The formation of gastric metaplasia in the duodenal mucosa may be related to a change of the microenvironment around the tissues, and duodenal mucosa may differentiate into gastric epithelium by the decrease of pH value.
