摘要
目的探讨宁波地区老年人常见上消化道疾病胃镜下表现的特点。方法回顾性分析2013年1月～2017年9月胃镜检查的老年组(≥60岁)10 294例与非老年组(16～59岁)43 718例,比较两组Barrett食管、慢性萎缩性胃炎、上消化道恶性肿瘤等发病率、发病部位等。结果 (1)老年人Barrett食管发病率高,明显高于非老年人(P<0.001),以岛型、SSBE为主。(2)老年人食管癌发病率高,好发食管中段,其次下段,以蕈伞型为主(P<0.05)。(3)老年人CAG发病率高(4.14%),但两组胃镜下肉眼检出与病理确诊符合率相差不显著(P>0.05);(4)老年人多为胃溃疡,好发非胃窦幽门区(P<0.001);溃疡面10～24 mm及>25 mm者较多见,癌变率高。(5)老年人胃癌多见,好发贲门胃底区(P<0.001),胃体区次之,Borrmann分型以Ⅰ型最多,直径较大。结论了解地区流行病学特征及掌握老年人胃镜下表现的特点,对老年人胃镜诊断有重要的指导作用,可提高早期胃癌及早期食管癌的诊断率。
Objective To investigate the features of gastroscopy in common upper digestive tract diseases in the elderly in Ningbo. Methods 10294 cases in the elderly group （≥60 years old） and 43718 cases in the non-senile group （16- 59 years old） who underwent gastroscopy from January 2013 to September 2017 were retrospectively analyzed. The in- cidences and？disease？site of Barrett＇s esophagus, chronic atrophic gastritis, upper gastrointestinal cancer and other diseases between the two groups were compared. Results ①The incidence of Barrett＇s esophagus in the elderly was high, which was significantly higher than that of the non-elderly people, with island-type and SSBE as the main factors （P〈 0.001）. ②The incidence of esophageal cancer in the elderly was high, and the cancer was usually occurred in the midst of the esophagus, followed by the lower section, with the fungating type as the main type （P〈0.05）. ③The CAG inci- dence of elderly patients was 4.14%, but there was no significant difference between the two groups in the coincidence rate of the endoscopic visually detection and pathological diagnosis （P〉0.05）. ④The elderly were mostly gastric ulcers, which were predominantly occurred in non-antral pyloric area （P〈0.001）. Ulcers 10-24 mm and 〉25mm were common, with high cancer rate. ⑤ Most of the elderly had gastric cancer, which usually occun＇ed in cardia gastricfundus area （P〈0.001）, followed by gastric body area. The Bolrmann type I was the most and had larger diameter in Borrmanhand. Conclusion To understand the regional epidemiological characteristics and to master the characteristics of endo- scopic findings in the elderly is important for the diagnosis of gastroscopy in the elderly, and it can improve the diag- nostic rate of early gastric cancer and early esophageal cancer.
作者
沈萍萍
张明明
陈汉卿
林琪
沙洪存
SHEN Pingpin;ZHANG Mingming;CHEN Hanqin;LIN Qi;SHA Hongcun(Department of Gastroenterology,Ningbo Yinzhou District Second Hospital,Ningbo 315000,China;Department of General Surgery,Ningbo Yinzhou District Second Hospital,Ningbo 315000,China)
出处
《中国现代医生》
2018年第27期96-100,共5页
China Modern Doctor
基金
浙江省宁波市科技计划项目(2015C50017)
关键词
老年人
胃镜检查
上消化道疾病
早期胃癌
早期食管癌
Elderly
Gastroseopy
Upper gastrointestinal disease
Early gastrie cancer
Early esophageal cancer
