77例良性食管溃疡的临床与内镜特征分析

Analysis of clinical and endoscopic features of 77 cases with benign esophageal ulcer

关键词:  良性食管溃疡  病因  内镜特征  幽门螺旋杆菌感染

Key words:  benign esophageal ulcer  etiology  endoscopic features  Helicobacter pylori infection

摘要:

目的 总结良性食管溃疡临床特征以及内镜特征，为临床诊治提供参考。方法 收集大连医科大学附属第一医院消化内科2006-2016年收治住院的77例良性食管溃疡患者的临床资料。对病因构成、年龄及性别分布、常见临床症状、内镜特征、内镜下活检病理结果、幽门螺旋杆菌（Helicobacter pylori）感染情况以及伴发疾病等进行统计分析。结果 临床特征：良性食管溃疡发病率男性高于女性（2.08：1），且老年患者（≥60岁）占比较高（48.1%）。反流性食管炎（57.1%）为最常见病因，其次是不明原因食管溃疡（23.4%）。内镜特征：良性食管溃疡多位于食管下段（48/77例），形态多为线性，其次是圆形/类圆形，直径多<2.5 cm，溃疡数目可以为单发或多发。结论 良性食管溃疡以老年男性多见，反流性食管炎为其首要病因，溃疡多为食管下段的直径<2.5 cm的线性溃疡，临床应加以重视，做到早诊断早治疗，提高患者的生活质量。

Abstract:

Objective To analyze the clinical features of benign esophageal ulcer, including its etiology, age and gender distribution, common clinical symptoms, and endoscopic features, in order to provide reference for the clinical diagnosis and treatment. Methods The records of 77 cases with benign esophageal ulcer patients admitted to the First Affiliated Hospital of Dalian Medical University from 2006 to 2016 were collected. The cause of the disease, age and gender distribution, common clinical symptoms, endoscopic features, endoscopic biopsy pathological results, Helicobacter pylori infection and concomitant diseases were analyzed. Results The incidence of benign esophageal ulcers was higher in men than in women (2.08:1), and elderly patients (≥60 years old) accounted for a relatively high proportion (48.1%). The main cause was reflux esophagitis (57.1%), followed by unexplained esophageal ulcers (23.4%). Benign esophageal ulcers were mostly located in the lower part of the esophagus (48/77 cases). The shape was mostly linear, followed by round/circular shape, and the diameter of the ulcer was usually less than 2.5 cm. The ulcer number was single or multiple. Conclusions Reflux esophagitis was the most common cause of benign esophageal ulcer. The endoscopic features of ulcer was usually linear with diameter less than 2.5 cm in the lower esophagus. More attentions should be paid for the early diagnosis, treatment in order to improve the life quality of benign esophageal ulcer patients.