有害毒物对胃黏膜的影响(1)
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中图分类号:R573
文献标识码: A
文章编号: 1672-3783(2009)-10-0001-03
【摘 要】目的 探讨部分毒物对胃黏膜的损害及其规律性。方法164例内服毒物自杀的患者在洗胃后即时由专人操作内窥镜检查,观察胃底、胃体、胃窦部,分别在以上各处钳取黏膜组织2～6块,HE染色镜检,对内镜观察结果分级分度,对8例患者进行了10 d至6月的随机走访。结果 164例100%异常,对照组中18例异常(18.0%),两组比较有显著性差异(P<0.01),胃黏膜病变为具有特征性的急性出血性糜烂性胃炎,随着中毒症状的恶化,内服毒物量的增加及毒性的上升,胃黏膜损伤加重,随着病情的改善而改善。结论 胃黏膜损伤是毒物内服时全身病变的一部分。
【关键词】毒物;胃黏膜病变
Influence of Person Gastric Mucosa Lesion in Patients Taking Poison
YANG Tie-li,WANG Jing
1Affiliated Hospital of Huanghuai University,Zhumadian 463000,Henan,China
2Nursery of HuangHuai University
【Abstract】Objective To study the regularity about gastric mucosa lesion in mankind having taken a part of poison.Methods Using the gastrasicopy and biopsy,the changes of gastric mucosa were investigated on 164 patients taking poison(male 54 cases,female 110 cases,aged from 15 to 32 years),and 100 cases of normal(male 34 cases,female 66 cases,aged from 18 to 35 years).GIS-105 gastroscopy made in Shanghai was used and operated for sole duty.The gastric mucosa in fundus antrum and copus were taken and stained with hemotoxylin and eosin(HE),and the results were compared with normal persons.The gastric mucosa lesion in 8 patients were followed up from 10d to 6mon. Results The abnormal rate of gastric mucosa was 100% in patients taking poison and 18.0% in control group(P<0.01).The characteristic changes of gastric mucosa in patients taking poison were acute hemorrhagic/erosio agent and improved with patients condition better correspondingly.Conclusion The pathological lesion of gastric mucosa in a part of the whole body in patient taking poison.
【Key Words】Poison; Gastric mucosa lesion
为探讨部分毒物对胃黏膜的损伤及其病变规律,作者自2000年12月至2009年2月对164例内服毒物企图自杀的患者,作了内窥镜检查,现报告如下。
1 资料与方法
1.1 检查对象 164例均为因各种原因致内服毒物企图自杀的患者,内服量5～300 mL不等,以15~50 mL为多(59.6%)。其中男54例,女110例,男女之比1:2.04,年龄15～32岁,平均24.8岁。城镇无业居民20例,农民136例,学生8例。另设同期不以消化道疾病而作内窥镜检查的100例患者作为对照,其中男34例,女66例,年龄18～35岁,平均25.6岁。164例均无胃病史,服毒后除中毒症状如流涎、肌颤外,出现心窝部不适154例,胸骨后及胃部烧灼感123例,胃部刺痛、钝痛、隐痛伴压痛者106例,恶心138例,呕吐125例,头昏、眼花、视物不清136例,胸闷、憋气85例,口中异物味感121例,呕血者15例,便血者32例,腹泻18例,神志障碍25例,低血压倾向28例,服毒至就诊洗胃时间15min～2.5h。
1.2 检查方法 采用上海光学医用仪器厂生产的GIS-105型纤维胃镜,于电动洗胃机洗胃后即时由专人常规操作观察,在胃底、胃体、胃窦部分别钳取黏膜组织2～6块,用10%福尔马林固定,石蜡包埋切片,HE染色镜检 ......
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