胃嗜酸性肉芽肿的临床内镜及病理特征

Clinical Endoscopic and Pathological Characteristics of Gastric Eosinophilic Granuloma

目的 :为了提高胃嗜酸性肉芽肿诊断及治疗水平。方法 :对 1976年 1月～ 1998年 4月收治的 4 1例胃嗜酸性肉芽肿的临床、内镜及病理学特征进行分析。结果 :男性发病率高。 4 0岁以下者占 6 2 .3%。患者病史较长 ,无消瘦 ,除合并上消化道出血患者外 ,亦无贫血。临床表现无特异性 ,并发溃疡率高 (92 .6 8% ) ,其中 15例作X线钡餐检查 ,误诊为胃癌 8例 ,胃溃疡 7例。 4 1例均作内镜检查 ,经胃镜确诊者仅 16例 (39.0 2 % ) ,手术切除疗效佳 ,无手术死亡与术后并发症。结论 :该疾病术前误诊率高 ,但只要仔细综合分析患者的临床与内镜下溃疡形态学特点 ,同时对可疑病变部位多处取材 ,行挖掘式活检 ,并作病理检查 ,就能提高术前诊断的准确率。在治疗上 。

Objective: To improve the level of diagnosis treament of gastric eosinophilic granuloma. Methods: The clinical endoscopic and pathological features of 41 patients with gastric eosinophilic granuloma were analysed from 1976 to 1998. Results: The incidence of disease was high among masculine patients (62.3%), The patients below 40 year older were majority of all. The complication of disease was the bleeding of the upper digestive tract and ulcer. The incidence of ulcer is 92.68%. Of 41 patients,15 were misdiagnosed as gastric cancer (8) and gastric ulcer (7) by barium meal examination. 16 (39.02%) of 41 patients exmined by gastroscopy were diagnosed as gastric eosinophilic granuloma. The curative effect of surgery treatment to the disease was eutherapeutic. Conclusion: The incidence of gastric eosinophilic granuloma's misdiagnose is very high. The misdiagnose incidence can be reduced with synthesis analysis to clinical endoscopic and pathological characteristics of the disease and biopsy. The preferred therapy of the disease is surgery treatment.