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食管大裂孔疝偶而表现为严重的缺铁性贫血,其病因可能是由于疝腰部小糜烂缓慢出血所致。本文旨在估测该病的发病率以及胃酸在糜烂的发病机理中所起作用。作者从过去5年间的5219例患者中,将确诊为本病的16例(0.31％)作为本研究的对象。16例中男性3例,女性13例,平均年龄70.1岁。观察期间有2人吸烟,4人服用过NSAID。大便潜血8例阳性,7例阴性。均有缺铁性贫血和大食管裂孔疝。内镜检查均见有疝腰部糜烂而无胃肠其他病变。9例在内镜下收集空腹胃液测定了pH,若干病人作了糜烂粘膜活检。16例中8人给铁剂治疗,其中8人随后加用了H_2受体拮抗剂,另8例自始至终同时服用铁剂与H_2受体拮抗剂,均于治疗6周后复查胃镜。
Esophageal hiatal hernia occasionally showed severe iron deficiency anemia, the etiology may be due to hernia slow erosion caused by small erosion. This article aims to assess the incidence of the disease and the role of gastric acid in the pathogenesis of erosion. Of 5219 patients in the past five years, the authors identified 16 patients (0.31%) who were diagnosed as patients with this disease. In 16 cases, there were 3 males and 13 females, with an average age of 70.1 years. Two people smoked during the observation period and four took NSAID. Fecal occult blood was positive in 8 cases and negative in 7 cases. Have iron deficiency anemia and large esophageal hiatal hernia. Endoscopic examination showed a hernia lumbar erosion without other gastrointestinal lesions. Nine patients underwent endoscopy to collect fasting gastric juice for pH measurement and several patients underwent erosive mucosal biopsy. Of the 16 patients, 8 received iron treatment, 8 of whom subsequently received H 2 receptor antagonist, and the other 8 patients received iron and H 2 receptor antagonists from beginning to end. All patients underwent gastroscopy 6 weeks after treatment.