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目的探讨儿童胆汁反流性胃炎的临床表现及其胃黏膜病理学特征。方法回顾性分析67例胆汁反流性胃炎患儿(观察组)的临床资料,探讨其临床表现、胃镜所见及病理检查的特征,同时选取慢性胃炎患儿70例(对照组),对比两组患儿幽门螺杆菌(Hp)感染率以探讨Hp感染与胆汁反流性胃炎的关系。结果观察组所有患儿均表现为空腹或夜间加重的无规律脐周或上腹痛,伴上腹饱胀43例(64.2%),伴晨起口苦28例(41.8%),伴反酸、呕吐18例(26.9%),伴胸骨后或剑突下烧灼感4例(6.0%);胃镜检查所有患儿均可见粘液湖黄染、胆汁斑、幽门松弛或持续开放、胆汁反流,伴十二指肠球炎17例(16.8%),伴十二指肠球溃疡6例(9.0%),伴胃溃疡2例(4.8%);病理检查见21例患儿的炎症程度达2级,其他相关指标均在0-1级之间,且所有患儿均无腺体萎缩;观察组Hp感染发生率为23.9%(16/67),显著低于对照组的70.0%(49/70)(P<0.01),观察组不同病情患儿Hp感染率无统计学差异(P>0.05)。结论儿童胆汁反流性胃炎在临床主要表现为空腹或夜间为重、无明显规律的脐周或上腹部疼痛,胃镜可见粘液湖黄染、胆汁斑、幽门松弛或持续开放、胆汁反流,病理学主要表现为轻中度胃黏膜炎症改变,多无腺体萎缩,且与Hp感染并无明显相关性。
Objective To investigate the clinical manifestations and gastric mucosal pathological features of children with bile reflux gastritis. Methods The clinical data of 67 children with bile reflux gastritis (observation group) were retrospectively analyzed. The clinical manifestations, characteristics of gastroscopy and pathological examination were analyzed. Seventy children with chronic gastritis (control group) Group Hp infection rate in children with Hp infection and bile reflux gastritis relationship. Results All children in the observation group showed irregular umbilical or upper abdominal pain with fasting or nocturnal aggravation, with abdominal obstruction in 43 cases (64.2%), painful morning in 28 cases (41.8%) accompanied with acid reflux, Vomiting in 18 cases (26.9%), followed by sternum or xiphoid burning sensation in 4 cases (6.0%); gastroscopy were visible in all children with mucus lake yellow dye, bile stain, pyloric relaxation or continuous open, bile reflux, with Duodenal inflammation in 17 cases (16.8%), with duodenal ulcer in 6 cases (9.0%), with gastric ulcer in 2 cases (4.8%); pathological examination, 21 cases of infants with grade 2 , Other related indicators were in the 0-1 grade, and all children had no gland atrophy; the incidence of Hp infection in the observation group was 23.9% (16/67), significantly lower than the control group of 70.0% (49/70 ) (P <0.01). There was no significant difference in Hp infection rate between observation group and control group (P> 0.05). Conclusion Children with bile reflux gastritis in the clinical manifestations of fasting or nighttime weight, no obvious regular umbilical or upper abdominal pain, gastroscopy visible mucus lake yellow dye, bile stain, pyloric relaxation or continuous open, bile reflux, disease Neo-Confucianism mainly manifested mild to moderate changes in gastric mucosal inflammation, no more than atrophy of the glands, and Hp infection and no significant correlation.