食管裂孔疝内镜诊断探讨

A study of hiatus hernia by gastroscopy

６０例经Ｘ线检查确诊为滑动型食管裂孔疝病人作胃镜观察食管－胃连接部的改变。另３４例为对照组。经统计学处理发现：①所有食管裂孔疝患者齿状线均有上移，６８％病人上移≥２ｃｍ；②食管末端生理弯曲和狭窄处改变在两组间有显著性差异（Ｐ＜０．０１）；③食管裂孔疝患者的贲门切迹呈波浪样上翻改变且易识别；④９例患者在膈上见有明显疝囊。上述４点作者认为可作为食管裂孔疝的内镜诊断标准。

We have selected 60 cases sliding esophageal hiatus hernia patients proved by x-ray and studied their pictures of gastroesophageal junction by gastroscopy. In contrast to HH , 34 cases without HH also be studied by the same method. After statistically analyzing our data, we have found that :①Each HH patient( 100%)has circular extension of gastric mucosa above the diaphragm, 68% patients>2cm.②The angle of esophageal end is taken place change, two groups difference is significant(P≤0.01);③The cardial incisure shows undulated borders , the gastric mucosa and rugal folds can be observed to 'roll'over the rim of hiatus(76%HH patients), it is easilly recognizable.④Apounch f consisting of the upper portion of the stomach, is identified in 9 cases patients. We think : the four signs can be regarded as diagnostic criteria by gastroscopy to HH.