食管上段胃粘膜异位症32例临床分析

Clinical analysis of 32 cases of heterotopic gastric mucosa in the upper segment of the esophagus

目的探讨食管上段胃粘膜异位症的检出率、病理特点和诊治方法。方法观察分析32例食管上段胃粘膜异位症患者的临床、病理及治疗、随访情况。结果主要表现有上腹不适、反酸、咽部不适、进食哽噎感等症状。内镜下表现为橘红色或红色的岛状、圆形或椭圆形斑块。病理检查显示病变由含有主细胞和壁细胞为主的胃上皮组织组成,部分为鳞状上皮与胃上皮组织共存。经过抑酸治疗后症状消失或明显缓解。结论食管上段胃粘膜异位症患者中无痛胃镜中的检出率为8.57%,在普通胃镜中的检出率为1.79%。大部分患者无相应的临床症状。诊断主要依据内镜下特征性的表现及病理活检。抑酸和抗幽门螺杆菌治疗可治愈或改善酸分泌所产生的症状。无异型增生者预后良好。

Objective To investigate the detection rate,pathological features and diagnosis and treatment of the upper esophageal submucosa heterotopic.Methods To observe and analyze the clinical,pathological,treatment and follow-up of 32 cases of gastric mucosa heterotopic of upper esophagus.Results the main manifestations of abdominal discomfort,acid regurgitation,throat discomfort,choking feeling of eating and other symptoms.An endoscopic,orange,or red island,round,or oval plaque.Pathological examination showed that the lesion was composed of gastric epithelial tissue,which was mainly composed of main cells and parietal cells,and partly coexisted in squamous epithelium and gastric epithelial tissue.The symptoms disappeared or were obviously relieved after the treatment of acid inhibition.Conclusion the detection rate of the painless gastroscopy in the upper esophagus of the esophagus is 8.57%,and the detection rate in the ordinary gastroscope is 1.79%.Most patients have no clinical symptoms.The diagnosis was based on the features of endoscopy and pathological biopsy.Acid suppression and anti Helicobacter pylori therapy can cure or improve the symptoms of acid secretion.No dysplasia with good prognosis.