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系统性硬化症患者胃肠道受累情况的临床评估

Clinical Assessment of Gastrointestinal Involvement in Patients with Systemic Sclerosis.

作者信息

Kaniecki Timothy, Abdi Tsion, McMahan Zsuzsanna H

机构信息

The Johns Hopkins Hospital, Department of Internal Medicine.

Johns Hopkins University, Division of Gastroenterology.

出版信息

Med Res Arch. 2020 Oct;8(10). doi: 10.18103/mra.v8i10.2252. Epub 2020 Oct 29.

Abstract

Systemic sclerosis (SSc) has the potential to affect any component of the gastrointestinal (GI) tract. GI involvement in SSc is a leading cause of morbidity and overall decreased quality of life in this patient population, identifying a need for a concise approach to work-up. This literature review aims to present a systematic, anatomical approach and differential diagnosis of GI involvement in SSc for the general internist and rheumatologist. Each component of the luminal GI tract has its own specified section, beginning with a review of a clinical approach to diagnosis that includes a differential for clinicians to consider, followed by a discussion of the literature surrounding objective evaluation of these conditions (i.e. serologic studies, imaging, endoscopy). Additionally there is a focused discussion on an approach to GI bleeding in the patient with SSc.

摘要

系统性硬化症(SSc)有可能影响胃肠道(GI)的任何组成部分。在该患者群体中,SSc累及胃肠道是发病和整体生活质量下降的主要原因,这表明需要一种简洁的检查方法。这篇文献综述旨在为普通内科医生和风湿病学家提供一种系统的、基于解剖学的方法以及对SSc累及胃肠道的鉴别诊断。胃肠道管腔的每个组成部分都有其特定的章节,首先回顾诊断的临床方法,包括供临床医生考虑的鉴别诊断,随后讨论有关这些病症客观评估的文献(即血清学研究、影像学、内镜检查)。此外,还重点讨论了SSc患者胃肠道出血的处理方法。

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本文引用的文献

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2019 Seoul Consensus on Esophageal Achalasia Guidelines.《2019年首尔贲门失弛缓症指南共识》
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ASGE guideline on the management of achalasia.ASGE 关于贲门失弛缓症治疗的指南。
Gastrointest Endosc. 2020 Feb;91(2):213-227.e6. doi: 10.1016/j.gie.2019.04.231. Epub 2019 Dec 13.
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Clinical Practice Guidelines for the Assessment of Uninvestigated Esophageal Dysphagia.未经调查的食管吞咽困难评估临床实践指南
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Colonic and Anorectal Manifestations of Systemic Sclerosis.系统性硬化症的结肠和肛门直肠表现
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Am J Gastroenterol. 2019 Sep;114(9):1441-1454. doi: 10.14309/ajg.0000000000000260.

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