胃镜下热极治疗疣状胃炎的临床研究

目的观察内镜下热极治疗疣状胃炎的临床疗效。方法对31例疣状胃炎采用内镜下热极治疗，术后给予奥美拉唑20mg．每日2次，共4周。对照组仅给予奥美拉唑20mg．用法相同。两组中幽门螺杆菌阳性者加用阿莫西林1．0，每日2次，甲硝唑0．4，每日2次，共1周。结果治疗组疣状糜烂愈合和临床症状缓解显著高于对照组（P〈0．01～0．05）。结论内镜下热极治疗疣状胃炎疗效确切，操作简单，值得临床推广应用。     

内镜下局部使用止血药治疗出血性胃炎的护理

出血性胃炎又称急性糜烂性胃炎、急性胃粘膜病变或应激性溃疡，是以胃粘膜多发性糜烂出血为主要表现。我们1996～2003年经内镜下局部使用止血药治疗出血性胃炎病人1860例，现将护理体会总结如下。     

内镜热极治疗在胃隆起病变的临床应用

目的 探讨内镜热极治疗对胃隆起病变的疗效.方法 应用内镜热极治疗疣状胃炎、黄色瘤及胃息肉并观察其疗效.结果 内镜热极治疗疣状胃炎42例计185枚,胃黄色瘤11例计16枚,胃息肉17例计30枚,4周后复查胃镜,疣状胃炎、胃黄色瘤均一次治疗全部消除,愈合率达100%.胃息肉一次治疗消失16例,愈合率为93.33%.1例2枚直径>1.5 cm亚蒂息肉基底局部组织仍有溃疡面,予第二次热极治疗后病灶完全消失、平复.结论 热极治疗是一种安全有效的治疗胃隆起病变的新方法.     

内镜下氩离子凝固术治疗疣状胃炎56例的疗效观察

目的探讨氩离子凝固术对疣状胃炎的治疗效果.方法在内镜直视下,采用氩离子凝固器,经内镜钳道插入氩气电凝导管,直至病灶上方0.3～0.5 cm处,以每次1～3 s的时间对疣状胃炎进行氩离子凝固术治疗.结果56例疣状胃炎患者临床症状明显改善,内镜复查病灶消失.结论氩离子凝固术治疗疗疣状胃炎是一种疗效确切,安全性好,副作用少的方法.     

三联疗法治疗糜烂性胃炎临床观察

目的 观察三联药物疗法治疗糜烂性胃炎临床4周疗效。方法 口服洁维乐凝胶20g，奥美拉唑10mg，阿莫西林片500mg，三联药物均为每日2次，总疗程4周。给药治疗4周后评估症状改善程度，内镜及病理切片观察胃黏膜变化情况。结果 75例患者完成4周治疗疗程。试验组与对照组症状均较治疗前有显著性改善（P〈0．05），试验组与对照组症状比较也有显著差异（P〈0．05）。试验组与对照组内镜下糜烂愈合总有效率有显著性差异（P〈0．05）。结论 三联疗法对糜烂性胃炎患者的症状有显著改善作用，能促进胃黏膜糜烂的愈合，减轻炎症反应，提高治愈率。     

慢性胃炎的内镜分型分级探讨

目的对慢性胃炎的内镜诊断统一规范，指导临床治疗。方法对1281例内镜诊断为慢性胃炎的患者按内镜表现红斑、糜烂、萎缩、出血进行分型。结果浅表性胃炎708例，占55．3％；糜烂性胃炎437例，占34．1％；出血性胃炎94例，占7．3％；萎缩性胃炎42例，占3．3％。结论慢性胃炎内镜分型分级标准使慢性胃炎的内镜诊断规范，对临床有指导意义。     

胃镜下局部喷撒“消疡散”治疗糜烂性胃炎及消化性溃疡101例报告

糜烂性胃炎和消化性溃疡都表现为胃粘膜的损伤，糜烂性胃炎往往由于治疗不及时或不当发展为溃疡病。传统治法需８周方能治愈，我们在临床上异病同治，采用胃镜下局部喷撒“消疡散”治疗，缩短了疗程，降低了复发率。１资料与方法１．１一般资料自１９９０年以来收治２４４例糜烂性胃炎和消化性溃疡病人，年龄１９～６５岁，平均４０．３岁。诊断均符合１９８７年全国消化会议制定的标准。胃镜下观察胃溃疡（ＧＵ）溃疡直径≥０．５ｃｍ，十二指肠溃疡（ＤＵ）溃疡面直径０≥０．３ｃｍ，糜烂性胃炎糜烂面直径≥０．３。二。按３：３：１比例…     

醋酸染色结合窄带成像对胃黏膜隆起糜烂性病变的诊断价值

胃黏膜隆起糜烂性病变通常指慢性糜烂性胃炎（隆起型）或疣状胃炎，是一种常见的具有特征性形态和病理变化的特殊类型胃炎。病因和发病机理尚未完全阐明，可能与幽门螺杆菌感染及免疫变态反应有关，目前尚无肯定有效的治疗方法。本病有癌变倾向，定期内镜和病理组织学检查及时发现癌前病变对预后非常重要。     

热极治疗疣状胃炎的临床疗效观察

目的 研究热极治疗对疣状胃炎的临床疗效。方法 60例疣状胃炎患者随机分为对照组及治疗组，治疗组内镜下应用热极配合质子泵抑制剂（雷贝啦唑）和黏膜保护剂（膜固思达）治疗疣状胃炎；对照组应用质子泵抑制剂（雷贝啦唑）和黏膜保护剂（膜固思达），疗程均为4周。结果 治疗组患者临床症状缓解和胃内疣状结节消失率显著高与对照组（P〈0．01）。结论 热极结合抗酸及粘膜保护剂治疗疣状胃炎的疗效优于常规疗法。     

经无痛胃镜氩离子凝固术治疗上消化道息肉及隆起糜烂性胃炎的疗效观察

我院从2003年10月起在无痛消化内镜下应用氩离子凝固术对上消化道息肉及隆起糜烂性胃炎进行治疗,疗效满意。     

Gastritis Varioliformis

A patient with chronic erosive gastritis and protein-losing gastropathy is reported. Presentation was with weight loss and abdominal discomfort. There were endoscopic and radiological features of erosive gastritis. Radioactive chromium studies confirmed that the low serum albumin was associated with fecal protein loss. No improvement occurred with bed rest or Caved S but coincided with DeNol therapy.     

Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis

Background : Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. Methods : One hundred and fifty‐five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. Results : Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. Conclusion : Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated.     

Gastric antral erosions and Helicobacter pylori infection in cirrhotic patients: a pilot controlled study of oral bismuth vs ranitidine therapy.

A controlled study was performed comparing bismuth and ranitidine oral therapy in the treatment of chronic antral erosions and chronic active gastritis and in clearing Helicobacter pylori in cirrhotic patients. Forty four patients took part in the randomized study. H pylori was present in more than 50% of the patients in the study. There was a close association between the presence of H pylori and inflammatory activity of gastritis at an antral level (p less than 0.001). CBS was significantly better than ranitidine in clearing H pylori (p less than 0.001) and reducing inflammatory activity of gastritis (p less than 0.001). This reduction was related to H pylori clearance. No action of the two medications was observed in improving endoscopic findings of erosive gastritis. H pylori clearance did not influence amelioration of endoscopic chronic erosive antral gastritis (EG) in cirrhotic patients. These findings suggest that H pylori does not seem to play a pathogenetic role in the aetiology of EG in cirrhotic patients while it represents an important factor in determining and maintaining the inflammatory activity of histologically confirmed gastritis in these patients.     

Lower Serum Level of Adiponectin Is Associated with Increased Risk of Endoscopic Erosive Gastritis

Background

Obesity is recently known as a risk factor for endoscopic gastritis. Adiponectin is an anti-inflammatory cytokine secreted from fat tissue, and its serum concentrations are reduced in obesity. The relation between adiponectin and gastritis remains unclear.

Aims

The aim of this study was to determine whether lower serum adiponectin level is associated with the risk of endoscopic gastritis.

Methods

We analyzed medical records of participants of a routine health check-up examination. Association among endoscopic findings, serum adiponectin level, and other clinical factors including age, sex, alcohol habit, smoking habit, body mass index (BMI), blood pressure, cholesterol, triglyceride, glucose, and insulin were investigated. Endoscopic erosive gastritis was defined as a flat or minimally depressed white spot surrounded by a reddish area or small elevation with central umbilications mimicking octopus?? suckers.

Results

A total of 2,400 participants were enrolled. BMI was significantly higher in gastritis-positive participants than in gastritis-negative participants. Serum adiponectin levels were significantly lower in gastritis-positive participants than in gastritis-negative participants. Multivariate logistic regression analysis revealed that lower serum adiponectin level (OR 0.96; 95% CI 0.93?C0.99), smoking (OR 0.50; 95% CI 0.30?C0.80), higher blood pressure (OR 1.02; 95% CI 1.01?C1.03), and duodenitis (OR 1.8; 95% CI 1.00?C3.09) were significantly associated with endoscopic erosive gastritis.

Conclusions

Lower serum level of adiponectin may increase the risk of endoscopic erosive gastritis, independently of BMI. Our findings facilitate further study to clarify the role of hypoadiponectinemia in erosive gastritis.     

内镜下热探头治疗的动物实验与临床应用

应用自行研制的ＤＨＰ－Ａ型热探头治疗仪对大白鼠肠系膜动、静脉出血进行止血实验表明：其平均止血时间为１０秒，１８０℃持续电热鼠胃粘膜７秒未超过粘膜下层。应用热探头治疗４３例上消化道出血，有效率９５．３％；治疗上消化道息肉１１例，随访９例，消失７例；８例隆起糜烂性胃炎均一次治愈。治疗中未发生严重副作用。     

Relationship of erosive gastritis to the acid secreting area and intestinal metaplasia, and the healing effect of pirenzepine.

The extent of acid secreting areas and the distribution of intestinal metaplasia in patients with erosive gastritis, and the healing effects of pirenzepine were examined. Studies were done with the endoscopic Congo red-methylene blue test developed in our hospital. Compared with control patients with no gastroduodenal disease, erosive gastritis was associated significantly more frequently with large acid secreting areas, but little or no intestinal metaplasia was detected in the stomach. A double blind trial was carried out, using 100 mg pirenzepine tablets or placebo for three months in 43 patients with erosive gastritis. Endoscopically, complete healing was significantly more frequent in the pirenzepine treated groups three months after the start of the treatment, as compared with the placebo treated group (p less than 0.05).     

Corpus gastritis and erosive esophagitis: a report from the Middle East.

OBJECTIVE: To assess whether corpus gastritis due to Helicobacter pylori protects against erosive esophagitis in an area with high prevalence of H. pylori infection. METHODS: Biopsies obtained from gastric corpus and antrum in 151 patients with symptoms of gastroesophageal reflux disease were studied for presence of H. pylori and endoscopic evidence of gastritis. Presence and grade of esophagitis at endoscopy was recorded. RESULTS: Fifty-four (36%) patients had endoscopic esophagitis. Patients with severe esophagitis (>or= grade II) less often had active gastritis (15/45 vs. 55/98; p=0.02) and had a lower density of H. pylori (p=0.0003) than those without esophagitis. CONCLUSION: Active corpus gastritis due to H. pylori infection may protect against erosive esophagitis in patients with gastroesophageal reflux disease in the Middle East.     

Chronic Erosive Gastritis: A Clinical Study

In order to help clarify the clinical importance of chronic erosive gastritis, we describe our experience of 28 patients with this disorder who were seen over a 2-yr period. Twenty patients were male. Twenty-four patients presented with abdominal pain, for which no cause other than chronic erosive gastritis was found in 20 patients. Ten patients had pain for more than 1 yr. Three patients presented with painless vomiting. The antrum was involved in 27 patients and the body in 17 patients. There was no correlation between the number of erosions and the duration of symptoms. Double contrast barium meal was positive in nine of 21 patients. Of 19 patients treated with cimetidine, 15 improved clinically and six of eight had endoscopic improvement. The treatment of choice is unknown and controlled trials are needed. Symptoms in patients with chronic erosive gastritis appear to be due to the gastritis itself rather than to associated lesions.     

Misoprostol for the Treatment of Chronic Erosive Gastritis: A Double-Blind Placeho-ControUed Trial

Objective: To assess the efficacy of misoprostol for the treatment of chronic erosive gastritis and associated symptoms. Methods: We performed a double-blind controlled trial, administering 200-μg misoprostol tablets or placebo twice daily for 2 months to 48 patients with symptomatic chronic erosive gastritis. Symptomatology was assessed by means of a standard questionnaire at the beginning and at the end of the study, as well as endoscopic and histologic changes of the gastric mucosa. Results: At the end of the treatment period, a significant reduction in symptom score was observed in misoprostoi-treated (from 86.6 ± 66.2 to 17.6 ± 18.2, p < 0.001) but not in placebo-treated patients. Endoscopic score was significantly reduced at the end of the treatment period in the misoprostol group, compared with that of the placebo group ( p < 0.05). A significant reduction in the activity of histologic gastritis was observed only in patients on misoprostol. the prevalence of gastric colonization by Helicobacter pyiori was rather low (30%), and no effect of treatment was observed. Conclusions: Patients with symptomatic chronic erosive gastritis seem to profit from treatment with misoprostol: the treatment with misoprostol, but not with placebo, was effective in significantly reducing the extent of symptoms. Sucb an improvement was associated with a substantial improvement in the endoscopic and histologic appearance of the gastric mucosa.