嗜酸细胞性胃肠炎临床诊治及文献分析  

Diagnosis and Treatment of Eosinophilic Gastroenteritis

作　　者：黄曼玲[1] 孙圣斌[1] 宋敏[1] 张姮[1] 吴杰[1] 

机构地区：[1]湖北省武汉市中心医院消化内科,430014

出　　处：《中国全科医学》2013年第20期2386-2389,共4页Chinese General Practice

摘　　要：目的探讨嗜酸细胞性胃肠炎(EG)的临床特点及诊治方法,以期提高临床医师对本病的认识。方法回顾性分析我院收治的2例嗜酸细胞性胃肠炎患者的病历资料,并结合PubMed数据库检索相关文献进行复习,总结嗜酸细胞性胃肠炎的临床特点及诊治方法。结果我院收治的2例嗜酸细胞性胃肠炎患者均经内镜检查发现,其中1例服用糖皮质激素治疗,1例采用手术治疗,预后均较好。检索到的文献共报道了92例患者,其中23例(25.0%)患者有过敏性疾病史。主要临床表现为恶心、呕吐、腹痛、腹胀,浆膜累及者多伴有腹腔积液。92例患者均经内镜检查发现,内镜下表现无特异性,确诊仍需依靠病理检查。大部分患者服用糖皮质激素治疗取得较满意效果,少部分患者可有复发。结论嗜酸细胞性胃肠炎临床表现和内镜下表现均缺乏特异性,内镜检查是主要诊断方法,但确诊仍需依靠病理检查;患者可选择糖皮质激素治疗,预后良好,部分患者需要手术治疗,少部分患者可复发,但目前尚无恶变报道。Objective To investigate the diagnosis and treatment of eosinophilic gastroenteritis（EG）.Methods A retrospective analysis was performed on the clinical data of 2 EG patients and relevant literatures retrieved from PubMed database were reviewed to summarize its clinical features,diagnoses and treatment.Results The 2 patients were diagnosed through endoscopy,1 treated with corticosteroids,1 had surgical treatment.Both had good prognoses.In the retrieved literatures,a total of 92 patients were reported,including 23（25.0%） having history of anaphylactic diseases.The main clinical manifestations were nausea,vomiting,abdominal pains,bloating.Most of those who involved in serous membrane were accompanied by seroperitoneum.Ninety-two EG patients were found by endoscopy,but its manifestations under endoscope were not specific.Final diagnosis needed pathological examination.Most patients took corticosteroids and had satisfactory results,only a few had recurrence.Conclusion The clinical and endoscope manifestations are not specific.Endoscopy is a main diagnostic methods,but final diagnosis still needs pathological examinations.EG patients can choose corticosteroid treatment with good prognosis.Some patients need surgical treatment,only a few may relapse,but so far no malignant changes have reported.

关 键 词：胃肠炎 嗜酸性细胞 诊断 治疗 

分 类 号：R573.39[医药卫生—消化系统] R574[医药卫生—内科学]