Błaszak Antoni, Wojtuń Stanisław, Gil Jerzy, Wojtkowiak Marek
Wojskowy Instytut Medyczny w Warszawie, Klinika Gastroenterologii CSK MON.
Pol Merkur Lekarski. 2007 May;22(131):357-61.
Hiatal hernia seems to be one of the significant clinical problems. The criteria of its diagnosis, occurrence and possible influence on esophageal reflux disease are still controversial. The aim of this paper is to research the incidence of hiatal hernia based on endoscopic criteria of its diagnosis and its influence on other esophageal diseases.
More than 729 patients, to whom endoscopy was made, were examined. The accepted endoscopic features of hiatal hernia and other lesions which could be related to it and other characteristic features of esophageal reflux disease were searched.
On the basis of accepted diagnostic criteria the hiatal hernia was diagnosed in 44.16% of men and in 42.77% of women. There were no difference in hiatal hernia occurrence in relation to age, gender and weight. The endoscopic features of esophageal reflux disease were found in 36.14% of women and 61.47% of men. The statistically significant incidence was observed in patients with hernia 55.99% women and 74.51% men and without hernia respectively in 22.81% and 51.16%. Similar differences took place in specific types of gastroesophageal disease, especially endoscopic features characteristic for Barrett's esophagus were observed nine times more frequently in men with hernia. Types with erosions were observed twice as much in patients with hernia of both sex. Esophagus mucosae cloudiness was observed three times more frequently in women with hernia and 50% more frequently in women.
All the data suggests there is a significant coincidence between hiatal hernia and esophageal reflux disease.
食管裂孔疝似乎是一个重要的临床问题。其诊断标准、发生率以及对食管反流病的可能影响仍存在争议。本文旨在基于食管裂孔疝的内镜诊断标准研究其发生率及其对其他食管疾病的影响。
对729例以上接受内镜检查的患者进行了检查。寻找食管裂孔疝及其他可能与之相关的病变的公认内镜特征以及食管反流病的其他特征。
根据公认的诊断标准，男性食管裂孔疝的诊断率为44.16%，女性为42.77%。食管裂孔疝的发生率在年龄、性别和体重方面无差异。女性食管反流病的内镜特征发生率为36.14%，男性为61.47%。有疝患者中女性的发生率为55.99%，男性为74.51%，无疝患者中分别为22.81%和51.16%，差异具有统计学意义。在特定类型的胃食管疾病中也存在类似差异，尤其是在有疝男性中，巴雷特食管的特征性内镜表现出现的频率是无疝男性的9倍。有疝的两性患者中出现糜烂型的频率是无疝患者的两倍。有疝女性食管黏膜混浊的发生率是无疝女性的3倍，且比男性高50%。
所有数据表明食管裂孔疝与食管反流病之间存在显著相关性。
