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目的通过分析13家医院内镜诊断的糜烂性食管炎病例,探讨广东省糜烂性食管炎的患病情况。方法回顾性分析广东省13家大医院2003年全年上消化道内镜检查的所有病例共63 459例,以洛杉矶标准收集符合糜烂性食管炎诊断病例的内镜资料及相关信息进行分析。结果共检出糜烂性食管炎1263例,糜烂性食管炎A、B、C、D级的检出率分别为0.94%(599/63459)、0.69%(440/63459)、0.21%(132/63459)和0.14%(92/63459),总检出率为1.99%(1263/63459), 其中A、B级患者占82.3%(1039/1263)。糜烂性食管炎的严重程度随着患者的年龄的增加而增加(F=22.932,P<0.001)。男性病例明显多于女性病例,男:女=2.3:1。食管裂孔疝见于6.7%(85/ 1263)的病例,其平均年龄明显大于无食管裂孔疝患者(60.0±17.1 vs 49.5±16.8,P<0.001),但两组病变的严重程度情况相似。Barrett食管及食管狭窄等并发症发生率不高,分别为0.71%和0.63%。结论广东省糜烂性食管炎的内镜检出率为1.99%,以轻中度的A、B级为主,并多见于男性、年长患者,病变严重程度随患者年龄的增加而增加。
Objective To analyze the erosive esophagitis cases diagnosed by endoscopy in 13 hospitals and discuss the prevalence of erosive esophagitis in Guangdong Province. Methods A total of 63 459 cases of upper gastrointestinal endoscopy in 13 major hospitals in Guangdong Province were retrospectively analyzed. Endoscopic data and related information were collected from the Los Angeles criteria for the diagnosis of patients with erosive esophagitis. Results A total of 1263 cases of erosive esophagitis were detected. The detection rates of esophagitis A, B, C and D were 0.94% (599/63459), 0.69% (440/63459), 0.21% (132 / 63459) and 0.14% (92/63459), respectively. The overall detection rate was 1.99% (1263/63459), of which 82.3% (1039/1263) were in grade A and B patients. The severity of erosive esophagitis increased with the age of the patient (F = 22.932, P <0.001). Male cases were significantly more than female cases, male: female = 2.3: 1. Esophageal hiatal hernia was found in 6.7% (85/1263) of cases, with an average age significantly higher than those without hiatal hernia (60.0 ± 17.1 vs 49.5 ± 16.8, P <0.001), but the severity of the lesions was similar in both groups. The incidence of complications such as Barrett’s esophagus and esophageal stenosis was not high at 0.71% and 0.63%, respectively. Conclusions The endoscopic detection rate of erosive esophagitis in Guangdong Province is 1.99%, mainly in mild to moderate grade A and B, and more common in male and elderly patients. The severity of the disease increases with the increase of patients’ age.