消化科经典病例推荐-反流性食管炎

2017-11-14 MedSci MedSci原创

反流性食管炎是指胃食管反流病出现食管黏膜破损后的情况,多数患者深受其折磨,严重影响生活质量,近二十年全球的发病率都有上升趋势。中老年人、肥胖、吸烟、饮酒及精神压力大是反流性食管炎的高发人群。 病史: 患者为一58岁中年妇女,1年前,患者无明显诱因出现腹痛,为剑突下持续性隐痛不适,阵发性加重,疼痛放射至背心。疼痛无转移,伴腹胀,伴反酸、烧心、伴嗳气,饭后疼痛加剧。  无恶心、呕吐,无

反流性食管炎是指胃食管反流病出现食管黏膜破损后的情况,多数患者深受其折磨,严重影响生活质量,近二十年全球的发病率都有上升趋势。中老年人、肥胖、吸烟、饮酒及精神压力大是反流性食管炎的高发人群。 病史: 患者为一58岁中年妇女,1年前,患者无明显诱因出现腹痛,为剑突下持续性隐痛不适,阵发性加重,疼痛放射至背心。疼痛无转移,伴腹胀,伴反酸、烧心、伴嗳气,饭后疼痛加剧。  无恶心、呕吐,无纳差,无呕血,黑便,无畏寒、发热,无胸痛、胸闷,无心前区压榨感,患者行胃镜检查提示“慢性胃炎”,经治疗后好转,此后反复发作,经口服药治疗后好转。  1个月前,患者无明显诱因再次出现上述症状,进食油腻食物后出现腹泻,约3-4次/日,有腹痛,腹泻后腹痛缓解,伴黏液,无脓血。无头晕头痛、发热,未求进一步诊治故来我院,门诊以“腹痛待诊”收入我科。  患者患病以来,精神欠佳,睡眠差,食欲可,小便3-4次/日,大便1-4次/日,近期体重无明显减轻。  患者10年前曾因“胆囊结石、胆囊炎”行“胆囊切除术”,术后恢复可。否认“冠心病、高血压、糖尿病”病史,否认“肝炎、结核”等传染病病史

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createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2019-08-24 米娅mi

    0

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createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-12-03 jyzxjiangqin

    消化科经典病例推荐.

    0

  3. 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createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-26 jyzxjiangqin

    反流性食管炎的治疗.

    0

  4. 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createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462517, encodeId=885b146251eb7, content=<a href='/topic/show?id=d627101081d8' target=_blank style='color:#2F92EE;'>#食管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101081, encryptionId=d627101081d8, topicName=食管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b8756488272, createdName=天堂的云, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542876, encodeId=dccd15428e651, content=<a href='/topic/show?id=9d9265e5234' target=_blank style='color:#2F92EE;'>#消化科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65752, encryptionId=9d9265e5234, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-16 zhouqu_8
  5. 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topicName=消化科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=817913501465, createdName=12498717m70(暂无昵称), createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571608, encodeId=971115e1608b1, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261311, encodeId=b6bc26131150, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=371748, encodeId=2d353e1748ab, content=晕, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aaf91654565, createdName=米娅mi, createdTime=Sat Aug 24 20:04:43 CST 2019, time=2019-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266427, encodeId=4a6926642e04, content=消化科经典病例推荐., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Dec 03 09:42:09 CST 2017, time=2017-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264376, encodeId=78092643e6af, content=反流性食管炎的治疗., 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topicName=消化科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=817913501465, createdName=12498717m70(暂无昵称), createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571608, encodeId=971115e1608b1, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261311, encodeId=b6bc26131150, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Nov 26 07:23:26 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437274, encodeId=896a143e2744d, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, 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topicName=消化科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=817913501465, createdName=12498717m70(暂无昵称), createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571608, encodeId=971115e1608b1, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261311, encodeId=b6bc26131150, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-16 feifers
  8. 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createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462517, encodeId=885b146251eb7, content=<a href='/topic/show?id=d627101081d8' target=_blank style='color:#2F92EE;'>#食管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101081, encryptionId=d627101081d8, topicName=食管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b8756488272, createdName=天堂的云, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542876, encodeId=dccd15428e651, content=<a href='/topic/show?id=9d9265e5234' target=_blank style='color:#2F92EE;'>#消化科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65752, encryptionId=9d9265e5234, topicName=消化科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=817913501465, createdName=12498717m70(暂无昵称), createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571608, encodeId=971115e1608b1, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261311, encodeId=b6bc26131150, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-14 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

  9. 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topicName=消化科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=817913501465, createdName=12498717m70(暂无昵称), createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571608, encodeId=971115e1608b1, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261311, encodeId=b6bc26131150, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-14 杏林后生

    不错

    0

  10. 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topicName=消化科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=817913501465, createdName=12498717m70(暂无昵称), createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571608, encodeId=971115e1608b1, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Thu Nov 16 02:03:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261311, encodeId=b6bc26131150, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 14 21:06:07 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261263, encodeId=e91326126360, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/14/f7ea3d62d5d348f1838206110c4aa6d7.jpg, createdBy=d1622197002, createdName=杏林后生, createdTime=Tue Nov 14 16:11:06 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261249, encodeId=57ef261249d2, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Tue Nov 14 12:30:49 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-14 thlabcde

    好资料学习了!

    0

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