胃肠道血吸虫病的内镜与临床特征

Endoscopic and clinical characteristics of gastroenterological schistosomiasis

目的探讨胃肠道血吸虫病的内镜和临床表现,以减少漏诊和误诊。方法对内镜和病理确诊的168例胃肠道血吸虫病患者资料进行分析。结果168例胃肠道血吸虫病患者中,胃血吸虫病33例,肠血吸虫病135例。138例内镜检查表现为炎症型24例,溃疡型73例,增生型41例。病理以慢性萎缩增生为基本病理变化,黏膜层、黏膜下层或坏死组织中有多量血吸虫卵沉积或钙化。合并胃肠道肿瘤134例,发生率79.76%,其中胃癌23例,大肠癌111例。结论胃肠道血吸虫病的内镜及临床表现为多样性,并发症多,肿瘤发生率高,诊断依靠流行病学史、内镜和病理检查,应及时诊断治疗,定期随访。

[ Objective ] To explore the endoscopic and clinical manifestations of gastroenterological schistosomia- sis and to avoid mistaking diagnosis. [Methods] 168 cases gastroentemlogical schistosomiasis diagnosed endoscopieally and pathologically were analyzed. [Results] Among these 168 cases, there were 33 cases gastric schistosomiasis, 135 cases bowel schistosomiasis. 138 cases endoscopic manifestations as following： 24 cases inflammatory type 73 cases ulcerative type and 41 cases proliferative type respectively. Pathological study found chronoical mucosa atrophy and proliferations is character in gastroenterological schistosomiasis, and numerous ova or calcification deposited in mucosa and submucosa or necrotic tissue. There were 23 cases gastric carcinoma and 111 cases colorectal car- cinoma among 134 cases complicated with gastroenterological tumor（79.76%）. [Conclusion] With atypical endoscopic and clinical features, many complications including tumors, gastroenterological schistosomiasis should be treated and followed up timely. Diagnosis was based on epidemiological investigations, endoscopic and pathological examinations.