食管黏膜剥脱症临床特点及治疗  

Clinical features and treatment of esophageal cast in otolaryngology

作　　者：龙海珊[1] 王凝[2] 段鹏[3] 赵晶[4] 徐文[1] 韩德民[1] Long Haishan;Wang Ning;Duan Peng;Zhao Jing;Xu Wen;Han Demin(Department of Otolaryngology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),100730 [2]首都医科大学附属北京同仁医院消化内科,100730 [3]华北石油管理局总医院耳鼻咽喉头颈外科 [4]首都儿科研究所附属儿童医院耳鼻咽喉头颈外科

出　　处：《北京医学》2021年第1期42-45,共4页Beijing Medical Journal

摘　　要：目的总结食管黏膜剥脱症的临床特点。方法选取2015年1月至2019年12月首都医科大学附属北京同仁医院诊治的16例食管黏膜剥脱症患者,采集所有患者的病历资料,总结该病的临床特点及诊疗经验。结果 13例为典型食管黏膜剥脱症,8例表现为典型的食管入口处脱出管型膜性物,有剧烈呕吐史13例,胸骨后疼痛13例,吞咽困难11例及呕血10例。不典型食管黏膜剥脱症患者3例,仅表现为咽痛、贫血或黑便。急性期可行纤维喉镜和(或)胃镜检查,保守治疗多有效,远期观察无瘢痕形成及食管闭锁发生。结论纤维喉镜见管型膜状物自食管入口处脱出,应考虑食管黏膜剥脱症。不典型病例需行胃镜检查。由于该病常伴有胸骨后疼痛,应与Mallory-Weiss综合征、食管裂孔疝和冠心病相鉴别。保守治疗的效果和预后均满意。Objective To summarize the clinical features of esophageal cast. Methods The data of 16 patients with esophageal cast diagnosed in Beijing Tongren Hospital, Capital Medical University, between January 2015 and December2019 were retrospectively analyzed, the characteristics and treatment were summarized. Results There were 13 patients with typical symptoms, esophageal membranous extruded to orifice in eight cases, 13 cases with severe vomiting, 13 cases with retrosternal pain, 11 cases with dysphagia, 10 cases with hematemesis diagnosed by endoscopy. Three patients with atypical symptoms(pharyngalgia, anemia and melena) were diagnosed by gastroscopy. Endoscopy and conventional treatment were effective for emergency cases. No scarring and atresia happened. Conclusions Esophageal cast or called exfoliative esophagitis, is easily misdiagnosed as Mallory-Weiss syndrome, esophageal hiatus hernia and coronary heart disease because of the retrosternal pain. The characteristic is esophageal membranous extrudes to orifice. When an emergency patient without membranous cast in oral after severe vomiting, but complained retrosternal pain, dysphagia, and hematemesis, endoscopy should be executed. The patients with typical symptom need extensive investigation. The effect of general treatment and prognosis are satisfied.

关 键 词：食管 管型 剥脱 喉 内镜 

分 类 号：R571[医药卫生—消化系统]