内镜下十二指肠粘液池的变化及临床意义的探讨

ENDOSCOPIC EVALUATION OF THE CHANGES AND CLINICAL SIGNIFICANCE OF THE DUODENAL MUCUS POOL

十二指肠粘液池是内镜下常见的征象。为探讨十二指肠粘液池的临床意义,对250例病人的胃镜资料进行分析,发现其中184例的十二指肠球部有粘液池,检出率占73.6％,并根据十二指肠粘液池的内镜下特点可分为0°～Ⅲ°,本组0°:26.4％、Ⅰ°:37.2％、Ⅱ°:25.2％、Ⅲ°:11.2％。同时具有十二指肠粘液池和胃镜可见胆汁反流者61例,占33.15％,主要是Ⅱ°和Ⅲ°十二指肠粘液池者,尤以Ⅲ°均见胆汁反流。结合十二指肠粘液池的外观和性状,认为十二指肠粘液池与胆汁反流密切相关,是诊断胆汁反流的一项重要内镜指标之一。也讨论了十二指肠粘液池与消化性溃疡、慢性胃炎和幽门螺杆菌感染之间的关系。

In order to evaluate the changes and clinical significance of the duodenal mucus pool, the authors analysed the endoscopy examination results of 250 patients. A duodenal mucus pool was found in 184 cases, 104 males and 80 females, with a mean age of 43. 5. According to the field oi endoscopic vision at pylon, the duodenal mucus pool is di vided into 0~III degrees. The color and characteristics of the mucus pool were recorded. The detection rate of the-duodenal mucus pool was 73.6 % (0:26.4 % ; I:37. 2% ; II:25. 2 % ; III:11.2 % ). Bile reflux was encloscopically diagnosed in 65 patients (26 % ) . Patients with both bile reflux and a duodenal mucus pool account for 33. I 5 % of the 65 bile reflux patients. In conclusion, the duodenal mucus pool is an important endoscopic sign of bile reflux. The association between the duodenal mucus pool and chronic gastritis, peptic ulcers, and HP infection are also discussed in this paper.