自发性全段食管黏膜下血肿2例并文献复习  

Two cases of spontaneous whole-segment esophageal submucosal hematoma and literature review

作　　者：张发平[1] 束玲玲 鲁大林 ZHANG Faping;SHU Lingling;LU Dalin(Department of Radiology,Anhui Wannan Rehabilitation Hospital,the Fifth People’s Hospital of Wuhu,Anhui,Wuhu 241000,China;Department of Gastroenterology,Anhui Wannan Rehabilitation Hospital,the Fifth People’s Hospital of Wuhu,Anhui,Wuhu 241000,China)

机构地区：[1]安徽省皖南康复医院(芜湖市第五人民医院)放射科,安徽芜湖241000 [2]安徽省皖南康复医院(芜湖市第五人民医院)消化内科,安徽芜湖241000

出　　处：《中国医药科学》2024年第6期190-193,共4页China Medicine And Pharmacy

基　　金：安徽省芜湖市科技计划项目(2021cg39)

摘　　要：食管黏膜下血肿(ESH)是临床少见的疾病,首发症状多为胸痛,与其他胸痛疾病易混淆。本文回顾性分析安徽省皖南康复医院收治的2例自发性全段ESH患者的临床资料、胃镜及胸部CT资料。2例患者均为老年女性,均在无明显诱因下突发胸痛、吞咽困难,经过胃镜及胸部CT确诊。入院行禁食、抑酸、护胃、解痉、抗炎及补液等保守治疗,1例患者在入院第3天出现呕血,另1例患者在入院第2天便血,同时患者症状明显改善,分别于第11天和第15天顺利出院,1个月后复查ESH消失,均无复发。2例ESH保守治疗均取得良好的临床疗效,尤其在血肿减压(呕血和便血)的情况下,有助于患者的症状改善。本文对ESH发病机制、临床表现、诊断、治疗和转归进行文献复习,以期提高临床医生对本病的诊治水平。Esophageal submucosal hematoma(ESH)is a rare disease in clinical practice,with the initial symptom often being chest pain,which is easily confused with other chest pain diseases.This article retrospectively analyzes the clinical data,gastroscopy data,and chest CT data of two patients with spontaneous whole-segment ESH admitted to Anhui Wannan Rehabilitation Hospital.The two patients were elderly women who experienced sudden chest pain and dysphagia without obvious cause and were diagnosed through gastroscopy and chest CT.Upon admission,conservative treatments such as fasting,acid suppression,stomach protection,spasmolysis,anti-inflammation,and fluid replacement were performed.One patient experienced hematemesis on the third day of admission,while the other patient had bloody stools on the second day of admission.The patient’s symptoms improved significantly,and they were successfully discharged on the 11th and 15th days,respectively.After one month,ESH disappeared and no recurrence was observed upon re-examination.Conservative treatment of two cases of ESH has achieved good clinical efficacy,especially in the case of hematoma decompression(hematemesis and bloody stool),which helps to improve the patient’s symptoms.This article reviews the pathogenesis,clinical manifestations,diagnosis,treatment,and prognosis of ESH to improve the diagnosis and treatment level of clinical doctors.

关 键 词：食管黏膜下血肿 胃镜 体层摄影术 X线计算机 胸痛 

分 类 号：R655.4[医药卫生—外科学]