Rey J F, Lombart J, Bournerie A, Salvadori J M
Sem Hop. 1982 Apr 1;58(13):788-92.
In chronic uremic patient, two kinds of digestive troubles can occur: gastric or duodenal lesions secondary to an abnormal gastro-intestinal hormone excretion, and drug-induced disorders. Most of these manifestations were missed by usual barium meal and the use of routine endoscopic check-up can be particularly useful. We performed 70 gastroscopies in 67 chronic hemodialyze patients. Examinations were practiced immediately before dialysis with only a light sedation. We observed 39 lesions: 3 drug-induced gastritis, 15 erosive or pseudopolypoid inflammations of the polyric antrum, 2 gastric ulcers, 5 duodenal ulcers (two of them were linear), 2 peptic oesophagitis and 34 p. cent of our patients had marked duodenitis, most of these digestive abnormalities could be missed or overdiagnosed by using routine barium meal. In presence of the number and the therapeutic importance of these disorders, we think that a gastroscopy should be prescribed in three indications: uremic patients before the beginning of an hemodialyze treatment, chronic hemodialyze patients with unexplained anemia, check-up before renal transplantation where ulcerations are a major contra-indication. In such situations, gastroscopy seems an important progress for the management of this particular group of patients.
在慢性尿毒症患者中，可能会出现两种消化系统问题：继发于胃肠激素排泄异常的胃或十二指肠病变，以及药物引起的紊乱。常规钡餐检查往往会遗漏这些表现中的大多数，而使用常规内镜检查可能会特别有用。我们对67例慢性血液透析患者进行了70次胃镜检查。检查在透析前立即进行，仅给予轻度镇静。我们观察到39处病变：3例药物性胃炎、15例胃窦糜烂或假息肉样炎症、2例胃溃疡、5例十二指肠溃疡（其中2例为线状）、2例消化性食管炎，34%的患者有明显的十二指肠炎，使用常规钡餐检查，这些消化异常中的大多数可能会被漏诊或误诊。鉴于这些疾病的数量和治疗重要性，我们认为在以下三种情况下应进行胃镜检查：血液透析治疗开始前的尿毒症患者、原因不明贫血的慢性血液透析患者、肾移植前检查（溃疡是主要禁忌证）。在这种情况下，胃镜检查似乎是管理这一特殊患者群体的一项重要进展。
