CAJ | 학술논문

目的：探讨症状酷似冠心病的食管裂孔疝的临床特点，以减少该病误诊或漏诊的发生。方法对2000年1月至2013年12月，北京市普仁医院诊断的伴有胸痛的食管裂孔疝32例患者的临床表现、诱因与缓解方法、心电图表现等方面进行分析，食管裂孔疝的诊断采用电子胃镜检查及X线上消化道造影二种方法。结果32例患者的首先给予药物治疗以抑酸剂促进食管、胃排空药物等。24例患者症状明显缓解，好转出院。8例患者上述药物治疗效果失败转外科手术治疗。结论食管裂孔疝的症状与冠心病相似，对于中老年胸痛患者，除了考虑冠心病以外，应及时行X线检查或胃镜检查，可提高食管裂孔疝的检出率，以减少误诊和漏诊的发生。
목적：탐토증상혹사관심병적식관렬공산적림상특점，이감소해병오진혹루진적발생。방법대2000년1월지2013년12월，북경시보인의원진단적반유흉통적식관렬공산32례환자적림상표현、유인여완해방법、심전도표현등방면진행분석，식관렬공산적진단채용전자위경검사급X선상소화도조영이충방법。결과32례환자적수선급여약물치료이억산제촉진식관、위배공약물등。24례환자증상명현완해，호전출원。8례환자상술약물치료효과실패전외과수술치료。결론식관렬공산적증상여관심병상사，대우중노년흉통환자，제료고필관심병이외，응급시행X선검사혹위경검사，가제고식관렬공산적검출솔，이감소오진화루진적발생。
Objective To explore the clinical characteristics of esophageal hiatal hernia similar to coronary heart disease,in order to reduce the misdiagnosis or missed diagnosis of hiatal hernia.Methods From January 2000 to December 201 3,32 cases of who presented a chest pain were diagnosed as hiatal hernia in our hospital.The clinical manifestations,causes and mitigation methods,ECG,and etc.were analyzed. Hiatal hernia was diagnosed by two methods:electronic gastroscopy and X-ray upper gastrointestinal contrast. Results The patients initially received drug treatment,such as antacids and drugs for promoting esophageal, gastric emptying.24 patients were improved and then discharged from hospital.While,8 conversions to surgical treatment were necessary due to failure of drug treatment.Conclusions Esophageal hiatus hernia may have similar symptoms with coronary heart disease.For aged patients with chest pain,in addition to the consideration of coronary heart disease,we should give X ray or gastroscopy examination in time,to improve the detection rate and to reduce the misdiagnosis and missed diagnosis of hiatal hernia.