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[目的]分析胃镜检出的食管裂孔疝(hiatal hernia,HH)的发病情况及内镜特点,探讨无痛胃镜对HH的临床诊断价值。[方法]对755例HH患者的内镜资料进行回顾性分析,对HH的检出率、无痛胃镜与普通胃镜下HH特点、HH发病年龄及性别、并发疾病进行对比分析。[结果]HH检出率为1.45%,无痛胃镜与普通胃镜HH检出率无明显差异(P>0.05);无痛胃镜与普通胃镜镜下差异主要是呕吐时食管腔内胃黏膜是否逆行疝入(P<0.05)。HH发病年龄主要集中在41~>60岁,检出率最高的合并症是反流性食管炎(57.61%,435/755;食管溃疡3例)。[结论]HH的主要内镜特征是齿状线上移,下方可见疝囊,食管裂孔压迹松驰、宽大。无痛胃镜检查能更直观的观察HH的特点及并发症,诊断HH具有重要的价值。
[Objective] To analyze the incidence and endoscopic features of hiatal hernia (HH) detected by gastroscopy and to explore the clinical value of painless gastroscope in the diagnosis of HH. [Methods] The endoscopic data of 755 patients with HH were retrospectively analyzed. The detection rate of HH, the characteristics of HH, the characteristics of HH, the age, gender and concomitant diseases of HH were analyzed. [Results] The detection rate of HH was 1.45%. There was no significant difference in the detection rate of HH between painless gastroscopy and conventional gastroscopy (P> 0.05). The difference between painless gastroscopy and conventional gastroscopy was mainly whether gastric mucosa Retrograde hernia (P <0.05). The age of onset of HH mainly concentrated in 41 ~> 60 years old. The highest detection rate was reflux esophagitis (57.61%, 435/755; 3 cases of esophageal ulcer). [Conclusion] The main endoscopic feature of HH is the shift of dentate line, and the hernia sac can be seen below. The esophageal hiatus marks relax and wide. Painless gastroscopy can be more intuitive observation of the characteristics of HH and complications, the diagnosis of HH has important value.