鼻饲饮食患者反流性食管炎内镜所见及临床特征分析

李涛; 王泳; 陆敏

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武警医学 ›› 2018, Vol. 29 ›› Issue (6) : 619-622.

论著

鼻饲饮食患者反流性食管炎内镜所见及临床特征分析

李涛¹,王泳¹,陆敏²

作者信息 +

Clinical and endoscopic features of reflux esophagitis in patients with nasogastric tube feeding

LI Tao¹,WANG Yong¹,LU Min².

Author information +

文章历史 +

摘要

目的探讨鼻饲饮食患者反流性食管炎(reflux esophagitis,RE)的内镜所见及临床特征。方法收集2005-01至2015-06经胃镜检查确诊的RE患者231例,分为两组:鼻饲饮食组156例,高龄老年组75例(≥80岁),按照洛杉矶标准分级,同时填写临床症状记录表。分析比较两组患者RE检出率、严重程度、胃镜下伴随上消化道疾病及临床症状等指标的差异。结果鼻饲饮食组RE内镜检出率67.2%,高龄老年组为24.4%,组间差异有统计学意义(χ2=21.23,P<0.05);其中鼻饲饮食组中重度RE所占比例44.3%,高龄老年组为30.6%,组间差异有统计学意义(Z=2.43,P<0.05)。鼻饲饮食组典型症状烧心反酸的发生率为20.5%,高龄老年组为26.7%,组间差异无统计学意义(χ2=3.84,P>0.05);而其呕血黑便发生率为37.1%,高龄老年组为12.0%,鼻饲饮食组显著高于高龄老年组,组间差异有统计学意义(χ2=16.61,P<0.05)。鼻饲饮食组患者合并胃溃疡的发生率28.8%,高龄老年组为10.6%,鼻饲饮食组高于高龄老年组,组间差异有统计学意义(χ2=9.47,P<0.05)。结论鼻饲患者中RE具有较高的内镜检出率,且食管炎性反应程度重,黏膜损害严重;并发胃溃疡的发生率高;典型症状烧心反酸发生率低,非典型症状呕血黑便发生率高。

Abstract

Objective To explore the clinical and endoscopic features of reflux esophagitis(RE) in patients with nasogastric tube feeding.Methods Totally 231 patients diagnosed with RE by endoscopy were collected and assigned to the group with nasogastric tube feeding(Group A,n=156) and the group of patients aged 80 or above(Group B,n=75).All the patients were classified according to the Los Angeles classification of RE and completed symptom questionaires.The incidence and severity of RE and clinical features were analyzed.Results The detection rate of RE was 67.2% in Group A and 24.4% in Group B,so the difference was statistically significant(χ2=21.23,P<0.05).The percentage of severe cases of RE was 44.3% in Group A and 30.6% in Group B,so the difference was of statistical significance(Z=2.43,P<0.05).There was no statistically significant difference in the incidence of typical symptoms of RE between the two groups,such as heartburn or regurgitation(χ2=3.84,P>0.05).However, the incidence of hematemesis and melena in group A was 37.1% ,compared to 12.0% in Group B,and the difference was statistically significant(χ2=16.61,P<0.05).The incidence of gastric ulcer in Group A was 28.8% and 10.6%in Group B, so the difference was of statistical significance(χ2=9.47,P<0.05).Conclusions Compared with patients aged 80 or above,patients with nasogastric tube feeding have a higher rate of endoscopic detection,fewer typical symptoms(such as heartburn and regurgitation), more atypical symptoms (such as hematemesis and melena),and more severe esophageal inflammation and a higher incidence of gastric ulcer.

导出引用

李涛,王泳,陆敏. 鼻饲饮食患者反流性食管炎内镜所见及临床特征分析[J]. 武警医学. 2018, 29(6): 619-622

LI Tao,WANG Yong,LU Min.. Clinical and endoscopic features of reflux esophagitis in patients with nasogastric tube feeding[J]. Medical Journal of the Chinese People Armed Police Forces. 2018, 29(6): 619-622

中图分类号： R571

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