食管黏膜剥脱症内镜及临床诊断分析  

Endoscopic and clinical diagnosis of the esophageal mucosa exfoliative disorder

作　　者：焦洋[1] 杨冬野[1] 张月寒[1] 王鼎鑫[1] 苏少慧[1] 

机构地区：[1]河北省人民医院消化内镜诊疗科,河北050051

出　　处：《新医学》2013年第1期45-47,共3页Journal of New Medicine

摘　　要：目的:探讨食管黏膜剥脱症的临床特点及内镜下形态表现,加强临床医师对该病的认识,以提高首诊准确率。方法:回顾性分析29例食管黏膜剥脱症患者临床及内镜检查资料,并进行综合分析。结果:纳入分析的29例患者资料分别来自消化内科16例,胃肠外科8例,心血管内科3例,耳鼻咽喉科2例。其中25例患者于发病前均有明确的过急进食粗糙坚硬食物或误食含骨性食物史。所有患者在发病过程中均有不同程度的恶心、呕吐症状。患者均以突发持续性胸骨后疼痛为首发症状,吞咽时疼痛加剧甚至伴有吞咽困难,随后出现呕血、黑便等临床表现。2例于呕吐时曾吐出灰白色条带膜状物。3例因既往有冠心病史,均被首诊为冠心病,其中1例因心电图提示急性前间壁心肌缺血并行溶栓治疗,致使消化道出血加剧。所有患者均未能在就医首诊时获得正确诊断。结论:食管黏膜剥脱症为临床上少见疾病,起病急,发病多有诱因,具有特征性的临床和内镜表现。进行内镜检查是诊断食管黏膜剥脱症的必要手段。诊断并无困难,关键在于临床及内镜医师对此疾病要有足够的认识。Objective： To investigate clinical features and endoscopic performance of the esophageal mucosa exfoliative, to strengthen the clinical subjects physician and improve the accuracy of the initial diagnosis. Meth ods： clinical and endoscopic examination of 29 patients with esophageal mucosa exfoliative disease were retrospec tively analyzed. Results： Sixteen cases were from digestive system department, 8 cases were from of gastrointestinal surgery department, 3 cases were from vasculocardiology department, and 2 cases were from E. N.T. There were 25 patients who eat too fast and eat rough hard food or food containing bone. In all patients, there were certain de gree of nausea, vomiting pathogenesis. Sudden persistent sternal pain was the first symptom, the pain got worse when swallowing even accompanied by dysphagia, even hematemesis, melena. Two patients spit offwhite Banding material. Three patients were first diagnosed as coronary heart disease because of previous history of coronary heart disease, one of those cases was treated with thrombolytic therapy because of electrocardiogram report of Acute ante riot partition myocardial ischemia, which resuhto gastrointestinal bleeding intensified. All the patients were not di gaosed correctly at first. Conclusions： Esophageal mucosa exfoliative was rare, acute disease, with clinical fea tures and endoscopic performance. It is necessary to endoscopy. The diagnosis was not difficult, but the key is to have enough understanding to such disease.

关 键 词：食管黏膜剥脱 胸骨后疼痛 内镜 诊断 

分 类 号：R571[医药卫生—消化系统]