小肠胃黏膜异位的临床特点并文献复习  

Clinical characteristics and literature review of ectopic gastric mucosa in the small intestine

作　　者：范正阳 龚亮 胡文墨 刘炜 游燕 吴东 Fan Zhengyang;Gong Liang;Hu Wenmo;Liu Wei;You Yan;Wu Dong(Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,State Key Laboratory of Difficult Severe and Rare Diseases,Beijing 100730,China;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,State Key Laboratory of Difficult Severe and Rare Diseases,Beijing 100730,China;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,State Key Laboratory of Difficult Severe and Rare Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院消化内科,疑难重症及罕见病全国重点实验室,北京100730 [2]中国医学科学院北京协和医院放射科,疑难重症及罕见病全国重点实验室,北京100730 [3]中国医学科学院北京协和医院病理科,疑难重症及罕见病全国重点实验室,北京100730

出　　处：《中华医学杂志》2024年第21期1998-2002,共5页National Medical Journal of China

基　　金：北京市自然科学基金(L232016)

摘　　要：总结小肠胃黏膜异位患者的临床表现,并通过文献复习比较国内外患者的临床表现差异。回顾性分析北京协和医院自2000年1月至2024年1月确诊为小肠胃黏膜异位的病例的临床特征。通过检索Pubmed、EMBASE、the Cochrane Library、万方、维普、知网等数据库;纳入时间为自数据库建库至2024年1月1日,对小肠胃黏膜异位进行文献复习。共纳入10例患者,均为男性,年龄[M(Q_(1),Q_(3))]为27(13~69)岁。病例多以消化道出血为首发表现,严重者出现失血性休克。腹部CT提示3例患者局部小肠壁增厚及肠腔狭窄。4例病变位于空肠起始段,6例位于回肠末段。所有病例均接受了局部病变切除术,术后病理证实为小肠胃黏膜异位。术后所有患者症状均消失,随访时间为0.5~3.0年。文献复习提示我国小肠胃黏膜异位临床主要表现为消化道出血;而国外患者多合并肠道重复畸形,并引发肠套叠,临床多以腹痛、呕吐为首发及主要表现。国内外女性患者肠梗阻发生率均高于男性;国内外患者回肠病变肠梗阻及合并小肠重复畸形的发生率高于空肠病变。局部小肠切除术是有效治疗方式,多预后良好。小肠胃黏膜异位较为罕见,消化道出血及肠梗阻症状为常见表现,可作为不明原因消化道出血的鉴别病因之一。The study aims to summarize the clinical characteristics of patients with ectopic gastric mucosa in the small intestine,comparing clinical presentation differences between domestic and foreign patients through literature review.The clinical characteristics of cases diagnosed with ectopic gastric mucosa in the small intestine at Peking Union Medical College Hospital from January 2000 to January 2024 were retrospectively analyzed.By searching databanks,such as PubMed,EMBASE,the Cochrane Library,Wanfang,VIP,CNKI,and etc(the inclusion period was from the establishment of the database to January 1,2024).The literature review was conducted on ectopic gastric mucosa in the small intestine.A total of 10 cases were included,all male,age[M(Q_(1),Q_(3))]was 27(13-69)years old.Gastrointestinal bleeding was the first manifestation in most cases,with severe cases leading to hemorrhagic shock.Abdominal CT indicated local intestinal wall thickening and luminal narrowing in 3 cases.Four cases lesions were located at the beginning of the jejunum and 6 lesions were located in the end segment of ileum.All cases underwent local lesion resection,with postoperative pathology confirming ectopic gastric mucosa.Symptoms disappeared postoperatively,with a follow-up period of 0.5-3.0 years.Literature review indicates that the main clinical manifestation of gastric mucosa ectopia in the small intestine in China is gastrointestinal bleeding,while foreign patients are often complicated with intestinal duplication and intussusception,with abdominal pain and vomiting as the primary and main symptoms.The occurrence rate of intestinal obstruction in female patients,both domestically and abroad,is higher than that in male patients.The occurrence rate of ileal lesions with intestinal obstruction and small intestinal duplication is higher than that of duodenal lesions in both domestic and foreign patients.Local small intestine resection is an effective treatment method with generally good prognosis.Ectopic small intestinal mucosa is relatively rare,w

关 键 词：胃黏膜 消化道出血 失血性休克 肠梗阻 

分 类 号：R574[医药卫生—消化系统]