电子胃镜检查在儿童慢性胃炎诊断中的应用价值  

Diagnostic value of electronic gastroscopy for chronic gastritis in children

作　　者：李亚梅 高萃[1] Li Yamei;Gao Cui(WardⅢ,Department of Pediatrics,Yan’an University Affiliated Hospital,Yan’an 716000,China)

机构地区：[1]延安大学附属医院儿科三病区,延安716000

出　　处：《中国实用医刊》2024年第21期62-64,共3页Chinese Journal of Practical Medicine

基　　金：2023年度延安市重点研发计划项目(SL2022SLSFGG-087)。

摘　　要：目的分析电子胃镜检查在儿童慢性胃炎诊断中的应用价值。方法回顾性抽取2023年4月至2024年4月延安大学附属医院收治的246例慢性胃炎患儿,均进行胃镜检查。以病理诊断结果作为金标准,分析电子胃镜检查对儿童慢性胃炎的诊断价值;分析慢性胃炎的电子胃镜下表现;对慢性萎缩性胃炎进行胃镜分型诊断。结果246例患儿经病理组织学检查发现,慢性萎缩性胃炎83例(33.74%,83/246),慢性浅表性胃炎163例(66.26%,163/246)。经电子胃镜检查发现慢性萎缩性胃炎63例,慢性浅表性胃炎136例,误诊47例。以病理组织学检查结果作为金标准,电子胃镜检查诊断慢性胃炎的灵敏度为75.90%(63/83),特异度为83.44%(136/163),准确率为80.89%(199/246),阳性预测值为70.00%(63/90),阴性预测值87.18%(136/156),Kappa值为0.581。慢性萎缩性胃炎和慢性浅表性胃炎患儿的电子胃镜下表现不同,两者红白相间(白为主)、红斑、红白相间(红为主)的发生率比较差异有统计学意义(P<0.05)。83例慢性萎缩性胃炎患儿中Ⅰ型慢性萎缩性胃炎患儿39例(46.99%,39/83),Ⅰ型+Ⅱ型慢性萎缩性胃炎患儿28例(33.73%,28/83),Ⅰ型+Ⅱ型+Ⅲ型慢性萎缩性胃炎患儿6例(7.23%,6/83),Ⅲ型慢性萎缩性胃炎患儿10例(12.05%,10/83)。结论电子胃镜能有效鉴别慢性萎缩性胃炎和慢性浅表性胃炎,对儿童慢性胃炎的诊断与病理组织检查结果较为一致,可为临床医生制定有效的治疗方案提供参考。ObjectiveTo analyze the diagnostic value of electronic gastroscopy for chronic gastritis in children.MethodsA total of 246 children with chronic gastritis admitted to Yan’an University Affiliated Hospital from Aprial 2023 to Aprial 2024 were retrospectively selected.And they all underwent gastroscopy examination.Taking results of pathological diagnosis as the golden standard,diagnostic value of electronic gastroscopy for chronic gastritis was analyzed.The manifestations of chronic gastritis under electronic gastroscopy were analyzed.The classifications of chronic atrophic gastritis were diagnosed by gastroscopy.ResultsIn the 246 children,histopathological examination showed that there were 83 cases(33.74%,83/246)with chronic atrophic gastritis and 163 cases(66.26%,163/246)with chronic superficial gastritis.Electronic gastroscopy showed that there were 63 cases with chronic atrophic gastritis and 136 cases with chronic superficial gastritis,including 47 misdiagnosis cases.Taking results of histopathological examination as the golden standard,sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value of electronic gastroscopy were 75.90%(63/83),83.44%(136/163),80.89%(199/246),70.00%(63/90),87.18%(136/156)and 0.581,respectively.Manifestations under electronic gastroscopy were different between chronic atrophic gastritis and chronic superficial gastritis.There were differences in the incidence of red and white(mainly on white),erythema,and red and white(mainly on red)between chronic atrophic gastritis and chronic superficial gastritis(P<0.05).In the 83 children with chronic atrophic gastritis,there were 39 cases(46.99%,39/83)with typeⅠchronic atrophic gastritis,28 cases(33.73%,28/83)with typeⅠ+typeⅡ,6 cases(7.23%,6/83)with typeⅠ+typeⅡ+typeⅢ,and 10 cases(12.05%,10/83)with typeⅢ.ConclusionsElectronic gastroscopy can effectively distinguish chronic atrophic gastritis from chronic superficial gastritis.There is good consistency between electronic gastroscopy and p

关 键 词：萎缩性胃炎 儿童 电子胃镜 慢性浅表性胃炎 诊断价值 

分 类 号：R725.7[医药卫生—儿科]