小儿慢性胃炎胃镜下形态和组织病理改变的研究

A study on association of gastroscopic and histologic mucosal changes in chronic gastritis of children

目的通过研究小儿慢性胃炎胃镜下形态与胃黏膜组织病理改变的关系,旨在提高小儿慢性胃炎诊断的准确性。方法以108例小儿慢性胃炎为研究对象,通过电子胃镜对胃黏膜进行形态学观察并取胃黏膜行组织病理检查,对胃镜下形态与相应组织病理改变进行对照分析。结果胃镜观察108例患儿均诊断为慢性浅表性胃炎,经组织病理检查诊断慢性浅表性胃炎106例,慢性萎缩性胃炎2例。106例慢性浅表性胃炎中伴淋巴滤泡形成15例(占14.2%),伴急性活动性炎症11例(占10.4%),伴肠化生2例(占1.9%)。组织病理Hp检测阳性43例(占40.6%),其中11例伴急性活动性炎症中有8例(占72.7%)Hp阳性,15例伴淋巴滤泡形成的慢性胃炎中有12例(占80.0%)Hp阳性。胃镜下表现为微小结节形成的儿童有更高的Hp感染率,而且Hp感染与炎症活动性及重度胃炎关系密切。结论小儿慢性胃炎绝大多数为慢性浅表性胃炎,不论是胃镜下形态还是病理学改变都与成人有一定的差别。胃镜检查对小儿慢性胃炎的诊断有较高的准确性,而且胃镜下形态特征与组织病理改变存在一定的联系。

Objective: To estimate the relationship between gastroscopic and histologic mucosal changes in chronic gastritis of children in order to improve the veracity of gastroscopic diagnosis. Methods: 108 children with chronic gastritis were selected, gastroscopic and histologic mucosal changes were diagnosed by gastroscope and histologic method. Results: All children were diagnosed chronic superficial gastritis by gastroscope; however, the pathologic results were different from gastroscopic results, there were 106 cases of chronic superficial gastritis and 2 cases of chronic atropic gastritis. There were 15 cases with dysplasia, 11 cases had acute active gastritis, 2 cases with intestinal metaplasia, 43 cases with helicobacter pylori infection. Conclusion: The gastroscopic and histologic mucosal changes in chronic gastritis of children were different from adults′, Moreover, some charactristical gastroscopic findings may be helpful to some pathologic diagnosis.