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胃石症与胃溃疡的病例特征及镜下特点分析

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目的:分析胃石症及胃溃疡的病例特点及溃疡的镜下表现,以更好地指导临床诊治。方法:筛选出2014年10月~2023年3月期间住院的155例胃石症患者作为病例组,155例胃溃疡患者作为对照组,从人口学特征、临床特点、镜下特点等进行统计学分析。结果:胃石症好发于女性,秋冬季节多发,其中山楂性胃石症在北方更常见,而胃溃疡好发于男性。胃石症合并糖尿病者(36.1%)明显多于胃溃疡合并糖尿病者(25.2%),而吸烟史、饮酒史及非甾体抗炎药(NSAIDs)服药史在胃溃疡患者中更常见。胃石症最常见的症状为腹痛(85.8%),最常见的并发症是消化性溃疡(68.4%)。胃石所致溃疡多为多发,平均长径为(15.94±11.92)mm,长径≥20 mm者占32.4%,溃疡较表浅,好发于胃角,更易治愈。胃溃疡多为单发,平均长径为(10.44±7.78)mm,长径≥20 mm者占13.1%,好发于胃窦。结论:与胃溃疡相比,胃石症更好发于女性及合并糖尿病者,腹痛、纳差等消化系统症状更常见,结合其镜下及影像学特点可更好地诊断胃石症,从而尽早警惕肠梗阻等并发症的出现。
Clinical characteristics and gastroscopic features of bezoar versus gastric ulcer
Objective:To analyze the clinical characteristics and gastroscopic features of bezoar versus gastric ulcer to guide their clinical diagnosis and treatment.Methods:Patients who were diagnosed with bezoar by gastroscopy or abdominal CT from October 2014 to March 2023 were included as cases, while those diagnosed with gastric ulcer by gastroscopy were included as controls. Statistical analyses were performed for comparisons between the two groups in terms of demoimagedata characteristics, clinical features, gastroscopic features, etc.Results:Bezoars were more common in females and prevalent in the autumn and winter seasons, and hawthorn bezoar was more common in north regions. Gastric ulcers were more common in males. Bezoars combined with diabetes (36.1%) were more common than gastric ulcers combined with diabetes (25.2%), while history of smoking, alcohol consumption, and history of taking NSAIDs were more common in patients with gastric ulcer. Abdominal pain (85.8%) was the most common symptom in patients with bezoar. The most common complication of bezoar was peptic ulcer (68.4%). Bezoar-induced ulcers were mostly multiple, with an average length of (15.94 ±11.92) mm, of which 32.4% were≥20 mm in length, and the ulcers were superficial, healed easily, and were prevalent in the gastric angle. Gastric ulcers were mostly solitary, with a mean length of (10.44 ± 7.78) mm, of which 13.1% were≥20 mm in length, and the ulcers were prevalent in the gastric sinus.Conclusion:Bezoars are more frequent in females and in patients with combined diabetes mellitus, and digestive system symptoms such as abdominal pain and nausea are more common in bezoars than in gastric ulcers. The combination of gastroscopic and imaging features can help diagnose bezoars as early as possible to prevent the development of complications such as intestinal obstruction.

郑晓、金晓维、王鹏、刘琳娜、欧阳皓、陈俊红、陈筱瑾

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100041 北京,北京大学首钢医院消化内科

胃石症 胃石所致溃疡 胃溃疡 镜下特点 并发症

2023

中华临床医师杂志(电子版)
中华医学会

中华临床医师杂志(电子版)

CSTPCD
影响因子:0.99
ISSN:1674-0785
年,卷(期):2023.17(11)
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