Barrett食管内镜临床诊断及病理特点分析

目的分析Barrett食管的临床症状、镜下表现及病理特点。方法回顾分析我院2007年10月-2009年10月间由胃镜及镜下活检病理学检查证实Barrett食管患者330例，分析其临床资料和胃镜表现。结果患者中男210例，女120例；以反酸（225例，68．2％）、烧心（204例，61．8％）及胸骨后痛（103例，31．2％）等为主要临床症状。镜下形态以岛型为主（280例，占84．8％），病变长度0．5～5．5cm，其中115例患者（34．8％）伴有食管裂孔疝。食管压力检查提示屏障压及食管中下段压力明显降低，酸反流总时间、总次数以及酸清除时间均明显增加。结论Barrett食管的临床症状与胃食管反流病无明显差别，是胃食管反流病的严重并发症；抑酸联合内镜下治疗为其提供了新的治疗方法。

Clinical and Pathological Features of Barrett Esophagus

Objective To analyze the clinical symptoms and endoscopic and pathological features of Barrett esophagus. Methods A retrospective analysis was made of the clinical data and endoscopic manifestations of 330 eases of Barrett esophagus confirmed by using endoscope and endoscopic biopsy and pathological examination in our hospital from Oct. 2007 to Oct. 2009. Results In 330 eases,210 males and 120 females,acid reflux accounted for 225 eases , 68.2% , heartburn 204 cases,61.8% and retrosternal pain 103 cases,31.2% as the main clinical symptoms. An island-based microscopy accounted for 280 cases, 84.8% ,with the lesion length of 0.5 -5.5cm, in which 115 cases（34.8%） were associated with esophageal hiatal hernia. Esophageal barrier pressure examinations showed the lower esophageal pressure was significantly lowered,while acid reflux total time,total number and acid clearance time were significantly increased. Conchlsion There was no significant difference in the symptoms between Barrett esophagus and gastrnesophageal reflux disease, with the former as a serious complication of the latter. Acid suppression combined with endoscopic therapy is a new treatment for Barrett esophagus.