海勤人员消化道常见疾病发病情况分析  

Incidence of common digestive tract diseases in the shipboard personnel

作　　者：曾巨浪 吕礁[2] 刘新[3] 曾晓虹[2] 方长华[3] 薛晶晶[2] 张莉[2] 崔佳佳[2] 

机构地区：[1]解放军第四二二医院,广东湛江524009 [2]解放军第四一一医院,上海200081 [3]海军上海保障基地医院,上海200083

出　　处：《海军医学杂志》2009年第4期329-332,共4页Journal of Navy Medicine

摘　　要：目的：了解海勤人员与陆勤人员消化道常见病发病情况，有针对性地做好海勤人员消化道疾病的防治。方法：收集2004年1月至2007年12月期间我院消化科门诊患者病史。消化道常见疾病诊断：病史、胃镜，同时病理活检排除癌性溃疡，上消化道钡餐排除皮革胃；其中反流性食管炎（reflux esophagitis，RE）诊断：症状sc积分≥8分者入选，胃镜检查排除食管狭窄、消化性溃疡、胃食管肿瘤，并根据1999年全国反流性食管炎研讨会制定的食管病变内镜诊断及分级标准进行诊断。反流食管病问卷调查（reflux diagnostic questionnaire，RDQ）对象为某部海、陆勤人员。按烧心感、胸骨后疼痛、反酸、反食等4大症状计分。RDQ≥20分者诊断为GERD，≤15分为非GERD但纳入研究，16～19分者不列入研究对象。结果：（1）海勤人员消化道出血发生率显著高于其他各人群，慢性胃炎发生率高于一般人群但低于基层部队（P〈0．05）。（2）海勤人员十二指肠球部溃疡（duodenal ulcer，DU）发病高于基层部队人群及机关人员，RE发病情况明显高于其他各人群（P〈0．05）。（3）RDQ积分随机问卷调查，海勤人员伴反流症状者发生率为26．81％，非海勤人员为9．26％。（4）门诊胃镜检查，症状Sc积分≥8分者中，海勤人员中诊断为反流性食管炎的31．55％，陆勤人员组为18．73％。结论：（1）随船医务人员要有针对性带足药品，做好十二指肠球部溃疡、反流性胃炎（reflux gastritis，RG）、RE和上消化道出血等高发病率疾病的治疗预案。（2）做好远航前的防治工作，出海前进行体检，对有明显消化道症状及溃疡病、上消化道出血病史等重点人员要安排消化道钡餐检查或直接行胃镜检查，必要时对高危患者进行工作调整。Abstract： Objective： To investigate the incidence of common digestive tract diseases in shipboard personnel and in land army and to effectively prevent from high incidence digestive tract diseases in shipboard personnel. Methods： Patients who visited our hos- pital during from Jan 2004 to Dec 2007 were collected as subject. Common digestive tract diseases were diagnosed in base on history, symptoms and gastroecopy. Among them, gastric ulcer caused by cancer was excepted by pathology check（biopsy） and linitis plastica was excepted in upper gastmimestinal tract barium meal. The patients with reflux esophagitis（RE） whose symptom Sc score was 〉t 8 were selected as subject, and esophagus straitness, peptic ulcer, gastric or gastric tumors were eliminated by gastroseopy. The judgment was accorded to the gastroesophaheal diagnosis and classification standard which was set down by China reflux esophagitis conference in 1999. According to heartburn stomachaches, retrosternal pain, acid reflux, food regurgitation, the scores of reflux diagnostic questionnaire（RDQ） were recorded. The patients whose RDQ scores were ≥20 were dignoseed as GERD and those whose Pd3Q scored were 415, not GERD. Subjects whose RDQ ,scores were among 16 - 19 were eliminated. Results： （1） In shipboard personnel, incidences of digestive tract were higher than in other crowd, incidences of chronic gastritis were higher than in ordinary pcople（P 〈 0.05）. （2）Incidence of duodenal ulcer（DU） in shipboard personnel was signifcantly higher than in department members or grass roots. On the eontra, that of RE was also significandy higher than other people（P〈0.05）. （3） The incidence of gastroesophageal reflux in shipboard personnel was 26.81%, 9.26 % in none shipboard personnel. （4）Among subjects whose gastroscopy Sc scores were ≥8, incedence d RE was 31.55% （59/187）in shipboard personnel and 18.73% （47/251） in land army（P〈 0.05）. Conclusion： （1）Medical members must prepare enough lee

关 键 词：消化道疾病 消化性溃疡 胃食管反流 航行 海勤人员 

分 类 号：R573[医药卫生—消化系统]