放大内镜下胃食管反流病患者食管乳头内毛细血管环形态学观察  

Observation on the clinical value of IPCL in gastroesophageal reflux disease

作　　者：汤红玲[1] 吴建维[1] 雷艳[1] 林丽嫂[1] 金玉珍[2] 

机构地区：[1]深圳市宝安区人民医院内一科(消化、肾内科),518101 [2]深圳市宝安区人民医院外一科(普外科),518101

出　　处：《中华现代护理杂志》2011年第21期2496-2498,共3页Chinese Journal of Modern Nursing

基　　金：深圳市科技计划项目（200803217）

摘　　要：目的探讨胃食管反流病（GERD）患者食管乳头内毛细血管环（IPCL）形态学检查在GERD诊断中的临床价值及护理。方法对非糜烂性食管炎（NERD）患者20例、糜烂性食管炎（EE）患者20例和10例健康志愿者行24h食管pH监测，采用白光和放大内镜窄波成像（NBI）模式观察食管下段黏膜IPCL形态并进行分型，同时配合有效的护理措施。结果3组受检者顺利完成内镜检查。NERD组患者24h食管pH监测阳性率为55％，EE组为90％，健康对照组均为阴性，NERD组低于EE组；放大内镜NBI模式下健康对照组食管IPCL呈茶色规律排列的卷发状、小螺旋状；NERD组85％及EE组100％食管IPCL形态为Ⅱ型，但仍排列规律，与健康对照组比较差异均有统计学意义（P〈0．05）。结论食管ICPL形态特异性改变有助于GERD的内镜诊断；高质量的护理配合对顺利完成内镜检查起到了重要的作用。Objective To explore the value of the morphological examination of intrapapillary capillary loop （IPCL） in diagnosis of gastroesophageal reflux disease （GERD） and nursing intervention. Methods 20 NERD, 20 erosive esophagi （EE） and 10 healthy volunteers were enrolled in this study, they were assessed with 24 hour ambulatory esophageal pH monitoring and pattern of IPCL which observed by magnifying endoscopy in narrow band imaging （NBI） mode, combined with nursing intervention at the same time. Results Patients receives endoscopic examination successfully. The positive rate of 24 hour ambulatory esophageal pH monitoring was 55% and 90% in the NERD patients and the EE patients, the healthy volunteers were negative. NERD patients were statistically lower than EE patients （P 〈 0. 05 ）, magnifying endoscopy in narrow band imaging （NBI）. Esophageal IPCL showed the regular curl type and small spiral type under the magnifying endoscopy, 85.0% sharp of esophageal IPCL in NERD group and 100% in EF group was type Ⅱ, but it still regularly arranged, there was statistically significant difference （ X^2 = 19.61,30. 00, P 〈 0. 05 ）. Conclusions The specific morphological changes of IPCL are useful to the endoscopic diagnosis of GERD. High quality nursing intervention is important to endoscopy.

关 键 词：胃食管反流 非糜烂性反流病 放大内镜 食管乳头内毛细血管环 

分 类 号：R571[医药卫生—消化系统]