食管裂孔疝伴反流性食管炎患者X线钡餐与内镜检查动力学对比研究  

COMPARATIVE ANALYSIS OF X RAY AND ENDOSCOPY IN 50 CASES OF HIATUS HERNIA COMPLICATED BY REFLUX ESOPHAGITIS

作　　者：叶萍[1] 李兆申[1] 许国铭[1] 邹多武[1] 卢任华[1] 

机构地区：[1]第二军医大学长海医院

出　　处：《解放军医学杂志》2001年第10期718-720,共3页Medical Journal of Chinese People's Liberation Army

基　　金：上海市卫生系统百人计划基金 (编号 98BR0 2 6 );上海市青年科技启明星计划 (编号 99QB14 0 45 )资助课题

摘　　要：为探讨X线钡餐与内镜检查在反流性食管炎合并食管裂孔疝 (HH)患者中的诊断价值以及两者在临床应用的优选问题 ,将 5 0例确诊为反流性食管炎伴食管裂孔疝患者分为HH1组 (A、B级 )和HH2 (C、D级 )。在 1周内行X线钡餐与内镜检查 ,并将结果进行对照分析。X线钡餐和胃镜检查中 ,两者疝囊诊断率为 10 0 %和6 0 % ,HH1组的反流方式以抽吸型为主 ,占 78 5 7% (2 2 / 2 8) ,而HH2组以倾倒型为主 ,占 81 82 % (18/ 2 2 )。HH1组的廓清方式以被动廓清为主 ,占 6 4 2 9% (18/ 2 8) ,而HH2组以延迟廓清为主 ,占 90 91% (2 0 / 2 2 ) ,且随着食管炎的加重而加重 ,延迟廓清呈逐渐增多趋势。内镜检查均可见食管粘膜炎症表现 ,食管下段粘膜以糜烂、溃疡为主。X线钡餐与内镜检查诊断符合率为 6 0 %。两种检查方法均适用于食管裂孔疝诊断 ,X线钡餐以简便、痛苦少而常首选。To compare the diagnostic value of X ray and endoscopy in reflux esophagitis (RE) in patients with hiatus hernia(HH) and their option in clinical practice. Correlative data of X ray and endoscopic findings in 50 cases of RE with HH were analysed.The radiography showed that there was 78 57% with the reflux type of suck and 64 29% with the clearance type of passivity in HH1 group, 81 82% with the reflux type of dumpage and 90 91% with the clearance type of delay in HH2 group. X ray and endoscopic diagnoses were corresponded 60% identically. Both examination methods are suitable for diagnosis of RE with hiatus hernia, X ray is the modality of first choice. Endoscopic exemination is indicated in cases of reflux esophagitis or other complications.

关 键 词：食管裂孔疝 反流性食管炎 放射摄影术 硫酸钡 动力学 内窥镜检查 

分 类 号：R655.4[医药卫生—外科学] R571[医药卫生—临床医学]