霉菌性胃溃疡的内镜、临床病理分析及防治研究

A Study on the Endoscope,Clinicopathology,Prevention and Treatment of Mycotic Gastric Ulcer

目的:探讨霉菌性胃溃疡的内镜、临床病理特征及防治方法。方法:对32例霉菌性胃溃疡进行内镜表现分析及病理组织学观察,内镜下清创后喷洒联合药物治疗并结合去除致病诱因。结果:霉菌性溃疡内镜主要表现为巨大溃疡,特点是大、深、不规整。少部分表现为片状糜烂、坏死及颗粒状。病理组织学表现主要为溃疡或糜烂灶的浅表炎性渗出坏死物及周围黏膜中见有数量不等的霉菌孢子或/和菌丝。治愈29例,治愈率90.6%。结论:霉菌性胃溃疡内镜下主要表现为巨大不规整溃疡,不易确诊。确诊主要依靠病理学检查。内镜下清创后喷洒联合药物治疗并结合去除致病诱因是治愈霉菌性胃溃疡、避免不必要手术、提高患者生活质量的有效方法。

Objective： To investigate the endoscopic and clinicopathological characteristics and methods of prevention and treatment of mycotic gastric ulcer.Method：The endoscopic findings and the histopathology from 32 cases of mycotic gastric ulcer were studied.All patients were treated by spraying combined drug on the ulcer after the endoscopic debridement,and combined with the removal of pathogenic incentives.Result：The major finding of endoscopy presented with huge ulcer whose distinguishing features were sizable,deep and uneven.A small number of them displayed with piece-form erosion,necrosis and granular form.The expression of pathohistology was that there were more or less mould spores or/and hyphae in inflammatory exudate and necrotic tissues on the surface of the ulcer and peripheral mucous membranes.29 cases were cured,the cure rate was 90.6%.Conclusion：The findings suggest that the mycotic gastric ulcer generally takes the form of uneven huge ulcer type under endoscopy check-up.Endoscopy screening is not easy to diagnose. Therefore,pathological examination is dependable.That endoscopic debridement and spraying combined drug,and combined with the removal of pathogenic incentives is an effective way to cure mycotic gastric ulcer,to avoid unnecessary operation and to improve the quality of life of the patients.