Association Of Clinical Manifestation And Drug Use With Endoscopic Detected Upper Digestive Tract Disease

AimWe performed a association analysis between endoscopic detected superior digestive tract disease types, distribution, clinical manifestations and past medical history by using subjects who accepted the inspection of gastroscopy in daily work in endoscopy room. Our purpose in this study was to provide scientific thereunder for improving the disease controlling of upper digestive tract disease by investigating the possible influence on correlativefactor of etiopathogenesis of upper digestive tract disease or prognosis.MethodPatients from the first affiliated hospital of Kunming medical university perceived all sorts of discomfort in2010November～2011June.Eliminating diagnosis can't clear and repeat gastroscope inspection. Investigators randomly sampled2150cases (male1090, female1060, minimum age6years old, maximum age89years old, standard deviation47.60+/-14.77years) which use of OLYMPUS-XQ240-1or OLYMPUS-XQ260-1model instrument underwent upper gastrointestinal endoscopy in endoscopy room.2004edition" digestive endoscopy" for reference in diagnostic criteria and gastroscope operation method. Detailed record of gastroscopic results,when necessary, combined endoscopy with biopsy. Repeated examinations recorded more severe lesions or pathologic diagnosis. By Purging or ELISA method for detection of HP infection. Using the unified formulation" gastroscopy investigation questionnaire" to collect subjects related information, including: the subjects of demographic characteristics, past medical history, eating habits of life, kind of medicine dosage regimens,psychological factor evaluation using the Hamilton anxiety scale. The subjects are divided into mild lesions, significant lesions, malignant lesions in3groups.The significant lesions are divided into inflammation, ulcer, divided3other subgroups. The SPSS18statistical software dealed with the data and P<0.05is considered as significant difference. Researchers observed upper gastrointestinal disease categories and detection rate order and searched related factors which may affect occurrence, development, and severity and its prognostic outcome in upper digestive tract disease.Result 1.Subjects are mainly from the city of Kunming (62.9%) and the eastern Yunnan Province (13.6%).A very small amount of Guizhou from Panxian (2.3%) and the north Yunnan Province (1.8%).2.2150cases were abnormal findings (positive rate100%).28kind of upper gastrointestinal diseases were detected, the top10diseases were superficial gastritis1984cases (92.28%), duodenitis in566cases (26.33%),325cases of duodenal ulcer (15.12%), reflux esophagitis in165cases (7.67%),110cases of gastric ulcer (5.12%),95cases of gastric cancer (4.42%), polyps in71cases (3.30%),53cases of esophageal carcinoma (2.47%), esophageal and gastric varices in49patients (2.28%),45cases of atrophic gastritis with (2.09%). All endoscopic abnormalities found in inflammation of the most common amounts to96%, the second of23%ulcer, tumor few can reach7%. Except for480cases of minor lesions (22.33%) and152cases of malignant lesions (7.07%),1670cases of significant lesions (77.67%) comprises796cases of inflammation (37.02%),475cases of ulcer (22.09%) and247cases of other lesions (11.49%).3. Men significant lesions detection rate of38%was significantly higher than the female (P<0.0001)32.6%.4. Significant lesion combined with hypertension in146cases (9.62%), combined with biliary tract disease in106cases (6.98%), taking nonsteroidal anti-inflammatory drugs in111cases (7.3%), Chinese medicine in169cases (11.1%), antibiotics in146cases (9.6%), minor lesion group corresponding to23cases (4.79%),19cases (3.96%),9cases (1.9%),26cases (5.4%) and24cases (5%), are more than mild lesion group (P<0.05). Tumor group compare with minor lesion group, combined with hypertension (9cases in5.92%and23cases4.79%), biliary tract disease (6cases in3.95%and19cases3.96%), taking nonsteroidal anti-inflammatory drugs (5cases in3.29%and9cases1.88%), Chinese medicine (14cases in9.21%and26cases5.42%), antibiotics (13cases8.55and24cases5%) showed no significant difference (P>0.05).5. Inflammation subgroup796cases, chronic superficial gastritis, chronic gastritis with bile reflux, chronic gastritis with erosion, reflux esophagitis and duodenitis is mainly distributed in31to60years of age.Chronic atrophic gastritis is mainly distributed in51to70years of age. Reflux esophagitis patients(52%) along with overweight or obese (P<0.01). Reflux esophagitis and duodenitis detection rate in males than in females (P0.05). Inflammatory diseaseaccording to the common sort, reflux esophagitis were abdominal pain (65.31%), acid regurgitation (42.86%), heartburn (42.86%), chest pain (24.49%), abdominal distension (33.67%); chronic atrophic gastritis were abdominal pain (72%), abdominal distension (36%), belching(28%), acid regurgitation (24%), nausea (20%); chronic superficial gastritis were abdominal pain (77.82%), abdominal distension (47.60%), acid reflux (33.96%), belching (24.12%), heartburn (20.75%); chronic gastritis with erosion were abdominal pain (82.14%), abdominal distension(48.14%), acid reflux (28.57%),belching (23.81%), anorexia (17.06%); chronic gastritis with bile reflux were abdominal pain(79.69%), abdominal distension (54.59%) belching(31.25%), acid reflux (29.69%), anorexia (21.88%); duodenitis were abdominal pain (78.69%), abdominal distension(51.73%), acid reflux (35.20%), belching(23.20%), nausea (16.80%).6. Ulcers group of475patients with a mean age of49.77+/-14.60years. Duodenal ulcer, esophageal ulcer are mainly distributed in31to60years of age (P<0.05), gastric ulcer, compound ulcer are mainly distributed in41to70years of age (P<0.05).The detection rate of gastric ulcer and duodenal ulcer is significantly higher than females (P<0.001).According to the common sort, duodenal ulcers were abdominal pain (85.23%), abdominal distension (41.23%), acid reflux (36.92%), belching(24.62%), nausea (20.92%); gastric ulcer were abdominal pain (75.45%),abdominal distension (42.73%), anorexia (25.45%), acid reflux (20%), belching (17.27%); compound ulcer were abdominal pain (80.65%), melena (32.26%), abdominal distension (38.71%), anorexia (19.35%), acid reflux (19.35%); esophageal ulcer followed by chest pain (55.56%), abdominal pain (44.44%),acid reflux (44.44%), heartburn (44.44%), dysphagia (33.33%).7.152cases of malignant lesions in patients with a mean age of58.86+/-12.43years, mainly in the41to70years of age.Male detection rate is significantly higher than females (80.26%versus19.73%, P<0.001). The most common chief complaint of gastric cancer are epigastric pain (84.8%), abdominal distension (47.8%), acid reflux (43.5%), weight loss (39.1%), belching (32.6%); esophageal carcinoma were dysphagia(88.4%), heartburn (48.8%), chest pain (41.7%), abdominal pain (34.9%), nausea (23.2%); postoperative patients with gastric cancer followed by heartburn (42.9%), abdominal pain (38.8%), abdominal distension (36.7%), languor (28.6%), weight loss (26.5%); postoperative patients with esophageal carcinoma followed by acid reflux (70%), heartburn (60%), abdominal distension (40%), anorexia(40%), weight loss(30%). Esophageal cancer pathological classification were poorly differentiated squamous cell carcinoma (48.8%) and differentiated squamous cell carcinoma (32.6%). Gastric cancer is mainly low differentiated adenocarcinoma (73.9%).8. Chronic gastritis, reflux esophagitis, peptic ulcer, gastric cancer, esophageal cancer and other disease received corresponding standard treatment, the clinical situation than before treatment improvement (P<0.05).Conclusion1.Gastroscope inspection of upper gastrointestinal diseases in order for chronic gastritis, peptic ulcers, polyps and tumors. The detection rate of ulcer men is higher than females.2.Subjects were diagnosed with gastroscopy for upper digestive tract disease with hypertension, biliary history, taking non-steroidal drugs, antibiotics, Chinese traditional medicine the rates are higher than minor lesions group.3.Endoscopic detection of superficial gastritis, chronic gastritis with bile reflux, chronic gastritis with erosion, reflux esophagitis and duodenitis are mainly distributed in31to60years of age, chronic atrophic gastritis is mainly distributed in51to70years of age. Reflux esophagitis seen in overweight or obese. The patient's with chronic upper gastrointestinal inflammation clinical nonspecific symptoms4.Esophageal ulcer and duodenal ulcer are mainly distributed in31to60years of age, gastric ulcer, compound ulcer are mainly distributed in41to60years of age. The detection rate of men is higher than female. Epigastric pain is peptic ulcer patients's symptoms.5.Gastric cancer and esophageal cancer is mainly distributed in41to70years of age.Postoperative patients with gastric cancer and esophageal cancer body slim or normal.The four illness male patients than in women. Advanced gastric carcinoma is characterized by abdominal pain, abdominal distention, acid reflux, emaciation, hematemesis and melena. Dysphagia and chest pain is the typical symptoms of esophageal carcinoma late. Esophageal cancer is poorly differentiated squamous cell carcinoma, followed by differentiated squamous cell carcinoma. Gastric carcinoma is poorly differentiated adenocarcinoma.6.After receiving correlative treatment,the clinic symptom of upper digestive tract diseases detected by endoscopic had alleviated in some extent already.