胃息肉的窄带成像结合放大内镜特点分析及其与幽门螺杆菌感染、背景黏膜之间的关系

发布时间：2018-05-13 10:55

  本文选题：胃息肉 + 幽门螺杆菌　； 参考：《遵义医学院》2017年硕士论文

【摘要】：目的:分析胃息肉与窄带成像结合放大内镜(NBI-ME)特点及其与幽门螺杆菌(H.pylori)感染、背景黏膜之间的关系,并提供有价值的信息来预测胃息肉的病理类型,判断病变良恶性,指导靶向活检。方法:收集336例胃息肉患者的一般临床特点、内镜及病理资料,分析不同病理类型胃息肉在发生年龄上、胃内分布上的不同,并探讨336例胃息肉与背景黏膜的关系、97例胃息肉与H.pylori感染的情况及103例胃息肉在NBI-ME下的表现。用统计学方法进行数据分析,计量资料以(?)表示,计数资料以百分率表示,构成比资料比较采用χ~2检验,当P0.05时,认为有统计学意义。结果:胃息肉常见于40到70岁之间;女性较男性多见;男女比为1:2.61。内镜下表现:以单发多见;其发生部位以胃体、胃底为主;直径多≤0.5cm;山田Ⅰ型和Ⅱ型占大多数(71.72%)。胃息肉病理类型以胃底腺息肉和增生性息肉常见,占胃息肉总数的绝大部分(89.29%),其中胃底腺息肉主要见于胃体和胃底,而增生性息肉发生部位较广,两者在胃内分布不同,具有统计学意义。在发生年龄上,胃底腺息肉和增生性息肉之间无统计学意义。增生性息肉的H.pylori感染阳性率为73.17%,胃底腺息肉的H.pylori感染阳性率为40.48%,两者之间具有统计学差异。在息肉背景黏膜表现中,胃底腺息肉背景黏膜表现为慢性非萎缩性胃炎者占95.35%,增生性息肉背景黏膜表现为慢性萎缩性胃炎者占27.34%,两者之间有统计学差异。在NBI-ME下,腺瘤性息肉的微细黏膜结构为长条状或脊状,微血管形态为密集形或中央形。炎性息肉的微细黏膜结构为长条状,微血管形态为密集形。胃底腺息肉和增生性息肉的微细黏膜结构分别以圆点状(83.72%)和长条状(84.45%)多见,微血管形态分别以蜂巢形(83.72%)和密集形(84.45%)多见,组合模式分别以圆点状+蜂巢形(83.72%)、长条状+密集形(82.22%)多见,且两者在圆点状和长条状的微细黏膜结构中、在蜂巢形和密集形的微血管形态中、在圆点状+蜂巢形、长条状+密集形的组合模式中均具有统计学差异。结论:胃底腺息肉好发于胃体和胃底,而增生性息肉发生部位较广;增生性息肉较胃底腺息肉的幽门螺杆菌感染阳性率高;内镜下胃底腺息肉的背景黏膜多表现为慢性非萎缩性胃炎,而增生性息肉的背景黏膜表现为慢性萎缩性胃炎者较胃底腺息肉者多。在NBI-ME下,胃底腺息肉和增生性息肉的表现不同。
[Abstract]:Objective: to analyze the characteristics of gastric polyp and narrowband imaging combined with magnifying endoscopy (NBI-MEA) and its relationship with H. pylori infection and background mucosa, and to provide valuable information to predict the pathological types of gastric polyps and to judge the benign and malignant lesions. Guide targeted biopsy. Methods: the general clinical features, endoscopic and pathological data of 336 patients with gastric polyps were collected and analyzed. The relationship between gastric polyps and background mucosa was discussed. 97 cases of gastric polyps and H.pylori infection and 103 cases of gastric polyps under NBI-ME were studied. Statistical analysis and measurement of data The count data was expressed as a percentage, and the composition ratio was compared with 蠂 ~ 2 test. When P0.05, it was considered to have statistical significance. Results: gastric polyps were common between 40 and 70 years of age; women were more common than men, and the ratio of men to women was 1: 2.61. Under endoscopy, most of them were single, the main site was gastric body and fundus, the diameter was less than 0.5 cm, and Yamada type 鈪，

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