29例胃十二指肠血吸虫病的内镜表现及病理特点分析

目的探讨胃、十二指肠血吸虫病的内镜和病理表现及预后。方法对29例胃、十二指肠血吸虫病患者的内镜下表现及病理表现进行分析，并根据随访资料进行预后分析。结果胃、十二指肠血吸虫病的内镜下表现缺乏特异性。29例中内镜下表现为溃疡17例，肿瘤样病变3例，浅表性胃炎2例，糜烂出血性胃炎1例，萎缩性胃炎6例。病理检查均在黏膜层、黏膜下层或坏死组织中发现有大量血吸虫卵沉积。29例中3例合并胃癌，另在最长11年的随访中发现癌变6例，癌变率达31％。结论胃、十二指肠血吸虫病内镜下表现缺乏特异性，诊断主要依靠病史和病理学检查，预后分析表明本病易产生癌前病变并易癌变，应定期随访以便早发现早治疗。

Analysis of endoscopic findings and clinicopathologic characteristics of 29 cases of gastroduodenal schistosomiasis

Objective To explore endoscopic findings,clinicopathologic characteristics,and prog- nosis of gastroduodenal schistosomiasis.Methods Twenty-nine gastroduodenal schistosomiasis patients were selected at random.Their endoscopic findings,and clinieopathologic characteristics were analyzed.Simulta- neously periodical follow-up investigations and prognostic analysis were performed.Results Endoscopic ap- pearances of gastroduodenal schistosomiasis were nonspecific.Among these 29 cases,endoscopic findings in- clude 17 cases of ulcerative lesion,3 cases of tumoroid lesion,2 cases of chronic superficial gastritis,1 case of erosive hemorrhagic gastritis and 6 cases of chronic atrophic gastritis.Clinicopathologic characteristics showed numerous ova deposited in mucosa,submucosa and/or necrotic tissues.During five to eleven years' follow-up investigations,6 cases had cancerous lesions.Therefore,the total canceration rate of gastroduode- nal schistosomiasis cases was 31%.Conclusion Endoscopic findings of gastroduodenal schistosomiasis were nonspecific.Diagnosis of gastroduodenal schistosomiasis was mainly based on patient history and clinicopath- ologic examinations.Prognostic analysis showed that it is prone to produce precancerous lesions and/or can- cerations.Therefore,periodical follow-up is extremely important for early diagnosis and treatment.