Mallory-Weiss综合征26例临床分析

Analysis of 26 cases with Mallory-Weiss syndrome

目的探讨Mallory-Weiss综合征的发病特点、诊断措施及有效的治疗方法.方法回顾性分析该院1999～2002年确诊的26例Mallory-Weiss综合征患者的资料,归纳分析其临床、内镜下表现.结果26例中男22例占84.1%,女4例占15.4%;30～60岁16例,占61.5%.26例均有频繁呕吐,4例女性均为妊娠期,19例男性为饮酒、暴食后,2例男性为幽门梗阻,1例男性为顽固性呃逆.26例撕裂均为纵向行撕裂,撕裂口最长4.0cm× 0.3 cm,最短0.6 cm× 0.2 cm;19例为单处撕裂,3例为2处撕裂,1例为3处撕裂,3例为浅红色瘢痕;前壁19例,占73.0%,右侧壁4例,占15.4%,左侧壁2例,占7.7%,后壁1例,占3.9%.结论呕吐是Mallory-Weiss综合征的共同症状,引起腹内压升高的因素均可诱发该病;男性多于女性,多发于30～60岁;男性多见于酗酒、暴食,女性多见于妊娠;撕裂多发生于前壁;急诊胃镜是确诊的重要手段,该病经内科治疗多有效.

Objective: To investigate the pathogenesis, diagnosis methods and the effective managements of Mallory-Weiss syndrome (MWS). Methods: Demographic characteristics, presenting symptoms and endoscopic variables of 26 patients admitted to our hospital from 1999 to 2002 were analyzed retrospectively. Results:22 patients were male (84.1%); 4 patients were female (15.4%); 16 patients (61.5%) ranged from 30 to 60 years old; All cases presented frequent vomiting; 4 female patients were in pregnancy;19 male patients were associated with alcoholism; 2 patients had pylorus obstruction; 1 presented persistent hiccupping. All lacerations were Longitudinal and ranged from 0.6×0.2 cm to 4.0×0.3 cm.19 cases had single laceration; 3 had 2 lacerations and 1 had 3 lacerations and 3 of them were pink scar. 19 cases (73.0%) had lacerations in anterior wall; 4 (15.4%) in right wall; 2 (7.7%) in left wall; 1 (3.9%) in posterior wall. Conclusions: Vomiting is the common presenting symptom. Sudden increase in intra-abdominal pressure secondary to any causes may provoke MWS. It often occurred in males and mainly from 30 to 60 years old. MWS in male is often associated with alcoholism while MWS in females often occurs during pregnancy. Tear or laceration occurred mainly in anterior wall or right wall. Most of patients with MWS were effective by only medical therapy.