期刊文献+

报警症状在胃肠道疾病诊断中的作用 预览 被引量:11

Clinical Value of Warning Symptoms and Signs in the Diagnosis of Gastrointestinal Diseases
在线阅读 下载PDF
收藏 分享 导出
摘要 根据报警症状区分器质性和功能性胃肠道疾病的确切作用尚不明了.目的:评价报警症状在上消化道或下消化道疾病诊断中的作用.方法:对2002年10月~2003年12月于上海第二医科大学附属仁济医院消化内镜中心行胃镜或结肠镜检查者中上海本地区患者的报警症状发生情况进行回顾性分析.结果:在14 101例因消化不良等症状行胃镜检查者中,发现食管、胃和十二指肠恶性肿瘤202例(1.4%),除1例早期胃癌外,其余均为中、晚期病例.有报警症状者108例(53.5%),其中45岁以下者的报警症状发生率为27.8%,黑便、贫血、进行性吞咽困难和持续或反复呕吐是较特异的报警症状.发现食管、胃和十二指肠良性器质性疾病4 017例(28.5%),有报警症状者1 281例(31.9%).胃镜检查无异常发现者9 882例(70.1%),有报警症状者381例(3.9%).在1 681例因下消化道症状行结肠镜检查者中,发现结直肠恶性肿瘤83例(4.9%),均为中、晚期病例.有报警症状者68例(81.9%),便血、黑便和贫血是较特异的报警症状,无报警症状的恶性肿瘤患者年龄均大于40岁.发现结直肠良性器质性疾病264例(15.7%),有报警症状者128例(48.5%).结肠镜检查无异常发现者1 334例(79.4%),有报警症状者197例(14.8%).结论:黑便、贫血、进行性吞咽困难和持续或反复呕吐报警症状有助于鉴别胃癌等上消化道恶性肿瘤与其他良性疾病,对无报警症状的成人消化不良患者作初始处理时,建议行胃镜检查.出现症状时年龄>40岁、便血、黑便和贫血报警症状有助于鉴别结直肠癌等下消化道器质性疾病与功能性疾病,当患者出现下消化道症状同时有报警症状时应行结肠镜检查,而40岁以上无报警症状的患者在作出功能性疾病的诊断前也应行结肠镜检查. Background: The precise value of distinguishing organic from functional gastrointestinal diseases by warning symptoms and signs has not been clarified. Aims: To assess the clinical value of warning symptoms and signs in the diagnosis of upper and lower gastrointestinal diseases. Methods: The prevalence of warning symptoms of consecutive autochthonous patients referred to the Endoscopy Center, Renji Hospital, Shanghai Second Medical University from October 2002 to December 2003 were analyzed retrospectively. Results: Two hundred and two (1.4%) esophageal and gastroduodenal malignancies were found by gastroscopy in a total of 14 101 patients presented with dyspepsia. Among them, except one was early, all others were moderately advanced or advanced. The overall occurrence of warning symptoms in this group was 53.5% (108/202), and 27.8% in those less than 45 years old. Melena, anemia, progressive dysphagia and continuous or recurrent vomiting were relatively common. Four thousand and seventeen (28.5%) cases of benign organic esophageal or gastroduodenal diseases and 9 882 (70.1%) cases without causal pathologic findings were found in these 14 101 patients, warning symptoms were present in 31.9% and 3.9% , respectively. Eighty-three (4.9%) patients with colorectal malignancies were found in 1 681 patients referred for colonoscopy due to lower gastrointestinal symptoms. All these malignancies were in the progressive stage. The presence of warning symptoms was 81.9% (68/83). Hemafecia, melena and anemia were the most common and significant alarming features. All malignant patients without warning symptoms were above 40 years old. Two hundred and sixty-four (15.7%) cases of benign organic colorectal diseases and 1 334 (79.4%) cases ~ith no causal pathologic changes were found in these 1 681 patients, and the presence of warning symptoms were 48.5% and 14.8%, respectively. Conclusions:Melena, anemia, progressive dysphagia and continuous or recurrent vomiting are helpful in disting
作者 李晓波 刘文忠 戈之铮 萧树东 Li XiaoBo;Liu WenZhong;Ge ZhiZheng;Xiao ShuDong
出处 《胃肠病学》 2005年第4期 198-202,共5页 Chinese Journal of Gastroenterology
作者简介 Email:liuwzmd@163.com
  • 相关文献

参考文献13

  • 1刘恩菊,项永兵,金凡,周淑贞,孙璐,方茹蓉,阮志贤,高立峰,高玉堂.上海市区恶性肿瘤发病趋势分析(1972~1999年)[J].肿瘤,2004,24(1):11-15. 被引量:130
  • 2Olden KW. Diagnosis of irritable bowel syndrome. Gastroenterology, 2002, 122: 1701~1714. 被引量:1
  • 3Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine E J, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut, 1999, 45Suppl 2: Ⅱ 43~Ⅱ 47. 被引量:1
  • 4Dogan UB, Unal S. Kruis scoring system and Manning's criteria in diagnosis of irritable bowel syndrome: is it better to use combined? Acta Gastroenterol Belg, 1996, 59:225~228. 被引量:1
  • 5Vanner S J, Depew WT, Paterson WG, DaCosta LR, Groll AG, Simon JB, Djurfeldt M. Predictive value of the Rome criteria for diagnosing the irritable bowel syndrome. Am J Gastroenterol, 1999, 94: 2912~2917. 被引量:1
  • 6Voutilainen M, Mantynen T, Kunnamo I, Juhola M,Mecklin JP, Farkkila M. Impact of clinical symptoms and referral volume on endoscopy for detecting peptic ulcer and gastric neoplasms. Scand J Gastroenterol, 2003, 38:109~113. 被引量:1
  • 7Boldys H, Marek TA, Wanczura P, Matusik P, Nowak A.Even young patients with no alarm symptoms should undergo endoscopy for earlier diagnosis of gastric cancer.Endoscopy, 2003, 35: 61~67. 被引量:1
  • 8Christie J, Shepherd NA, Codling BW, Valori RM. Gastric cancer below the age of 55: implications for screening patients with uncomplicated dyspepsia. Gut, 1997,41: 513~517. 被引量:1
  • 9Gillen D, McColl KE. Does concern about missing malignancy justify endoscopy in uncomplicated dyspepsia in patients aged less than 55? Am J Gastroenterol, 1999, 94:2329~2330. 被引量:1
  • 10Bodger K, Eastwood PG, Manning SI, Daly M J, Heatley RV. Dyspepsia workload in urban general practice and implications of the British Society of Gastroenterology Dyspepsia guidelines (1996). Aliment Pharmacol Ther,2000, 14: 413~420. 被引量:1

二级参考文献13

  • 1孙国桢.上海人口老龄化对医疗保障压力的对策研究[J].中国卫生资源,2001,4(2):86-88. 被引量:15
  • 2World Health Organization. Manual of the international statistical classification of diseases, injuries and causes of death, Vol 1[M]. WHO, Geneva 1977. 被引量:1
  • 3Esteve J, Benhamou E, Raymond L. Statistical methods in cancer research. Descriptive epidemiology Vol IV[M]. IARC Scientific Publications, No 128, Lyon, 1994. 被引量:1
  • 4Yu H, Harris RE, Gao YT, et al. Comparative epidemiology of cancers of the colon, rectum, prostate and breast in Shanghai, China versus the United States[J]. Int J Epidemiol, 1991, 20:76. 被引量:1
  • 5Hulka BS. Epidemiologic analysis of breast and gynecologic cancers[J]. Progr[J]. Clin Blot Res, 1997, 396: 17. 被引量:1
  • 6Hsing AW, Devesa SS, Jin F, et al. Rising incidence of prostate cacer in Shanghai, China [letter][J]. Cancer Epidemiol Biomarkers Prey, 1998, 7 : 83. 被引量:1
  • 7Gao YT. Risk factors for lung cancer among nonsmokers with emphasis on lifesyle factors [J]. Lung cancer, 1996, 14 (suppl1) :39. 被引量:1
  • 8Zhong L, Goldberg MS, Gao YT, et al. A case-control study of lung cancer and environmental tobacco smoke among nonsmoking women living in Shanghai, China[J]. Cancer Causes & Control, 1999, 10(6):607. 被引量:1
  • 9Yuan JM, Ross RK, Chu XD, et al. Prediagnostic levels of serum 13-Cryptoxanthin and retinal predict smoking-related lung cancer risk in Shanghai, China[J]. Cancer epidemiology biomarker & Prevention, 2001, 10:767. 被引量:1
  • 10Zhong L, Goldberg MS, Gao YT, et al. A population-based case-control study of lung cancer and green tea consumption among women living in Shanghai, China [J]. Epidemiology, 2001,12(6) :695. 被引量:1

共引文献129

同被引文献317

引证文献11

二级引证文献106

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈