| Objective Reflux Esophagitis is a common and frequently-occurring disease.The lighter reflux esophagitis is not easy to arouse the attention of patients.In recent years,several studies on the prevalence of reflux esophagitis under endoscopy have shown that the total number of patients is higher than previous Asian studies,and time-trend studies also show an increased prevalence of endoscopic reflux esophagitis.This article will study the performance characteristics of endoscopic positive reflux esophagitis patient,who have come to this hospital for endoscopic examination with the same symptoms for two times,such as the relationship of RE Los Angeles Grading and gastroesophageal flap valve grading,reflux esophagitis Los Angeles Grading and gastroesophageal flap valve grading grading's over time,initial diagnosis of reflux esophagitis patients with esophageal mucosal healing,and gastroesophageal flap valve grading grading and hiatus hernia changes,recurrence outcome of reflux esophagitis patients,analysis of changes in gastro-esophageal flap valve grading grading when patients with recurrent reflux esophagitis' s improved or worsened,whether reflux esophagitis is easy to happen at the same position and where the probability is high,whether reflux esophagitis is easy to happen at the same season and in which season the probability is high,the relationship between reflux esophagitis and Helicobacter Pylori infection,and the relationship between reflux esophagitis outcome and Helicobacter Pylori eradication.This article will do a clinical analysis of these problems,to explore the clinical features of the the mirror manifestations of the endoscopic positive re patients who have come back with the same symptoms.It aims at helping clinicians understand some of the general occurrence of reflux esophagitis.Methodes The reserch collected the patients who had twice endoscopic examination of upper digestive tract less than three years of Liaocheng People's Hospital between January 1,2017 to December 31,2017.All patients had these symptoms,such as acid reflux,heartborn,etc.And the patients who are diagnosed reflux esophagitis are up to 192 cases,and the first endoscopic diagnosis of reflux esophagitis get rid of tumor,esophageal varices leading by portal hypertension,pyloric obstruction,etc.At the same time statistics of the clinical parameters of the corresponding cases.For example,grading of reflux esophagitis,grading of gastroesophageal flap valve,the occurred parts of reflux esophagitis,the occurred seasons of RE,infection of HP,etc.Grading of reflux esophagitis depends on Los Angeles grading(LA grading),grading of gastroesophageal flap valve depends on classification of Hill standard grading.The occurred parts of reflux esophagitis are diagnosis according to left anterior wall,left posterior wall,right posterior wall,right anterior wall.The outcome of reflux esophagitis is divided into unchanged,improved and aggravated.Helicobacter Pylori according to fast urease test.Results 1.This study contains a total of 192 patients,at least two times the endoscopy,in order to ensure the randomness of the data,so use 3-8 years of first endoscopic data,the use of non-parametric Spearman rank correlation analysis of LA grading The relationship with gastroesophageal flap valve grade showed a positive correlation between the two indicators(r=0.301,P <0.05).2.192 patients were included in the study,and the average age is(49.93±11.451)years old,and the average interval of endoscopy was(4.88±1.386)years.Application of chi-square analysis respectively LA classification and grade of gastroesophageal flap valve changes over time,it is concluded that the two LA classification change was statistically significant(P < 0.05),gastroesophageal flap valve classification change has no statistical significance(P > 0.05).In 192 patients,150 cases of patients with recurrence of RE,the average interval of recurrence in patients with reflux esophagitis two endoscopic examination of(4.67+1.631)years,twice before and after RE recurrence in patients with LA classification and grade of gastroesophageal flap valve had no statistical significance(P> 0.05).3.In this study,a total of 150 recurrent patients with reflux esophagitis were included in the individual study,and patients with esophageal mucosal incompatibility were classified as light reflux esophagitis,ie Los Angeles graded A and B grades,and fusions were classified as heavy reflux esophagitis,ie Los Angeles grade C and D grades.There were 11 cases(7.3%)who had improved,10 cases(6.7%)had worsened,and 129 cases(86%)had not changed.The statistical analysis of the improved and the aggravated patients and their corresponding gastroesophageal flap valve grades showed that the patients' improvement and aggravation were not related to the gastroesophageal flap valve grade.4.Of 150 patients with recurrent reflux esophagitis part of chi-square analysis,it is concluded that the two lines of endoscopic check reflux esophagitis location between constituent ratio has no statistical significance(P>0.05),in included in the study of 192 cases of patients,statistical first line endoscopy reflux esophagitis location,it is concluded that reflux esophagitis occurred in 53 cases(27.6%),left anterior wall left after wall 47 cases(24.5%),posterior wall of 108 cases(56.3%),179 cases(93.2%)of the right front wall.5.Of 150 cases of patients with recurrence of reflux esophagitis,reflux esophagitis occurrence season chi-square analysis,concluded that patients before and after the two visits to occur between the constituent ratios of the season in reflux esophagitis no statistical significance(P > 0.05),line the first time in 192 cases of patients with endoscopic check happen 55 cases(28.6%)of patients in the spring,summer has 37 cases(19.3%),54 cases(28.1%),autumn winter 46 cases(24.0%).A total of 192 patients were studied in the study on their individual onset seasons.46 patients(24.0%)were seen in the same season,146(76.0%)were seen in different seasons,and 16(34.8%)were in spring visits in the same season.In the summer,there were 12 patients(26.1%)in the clinic,7 patients(15.2%)in the autumn,and 11 patients(23.9%)in the winter.6.A total of 42 patients with reflux esophagitis had complete esophageal mucosal healing.The average age at the time of initial diagnosis was(47.95±11.4)years,and the average age at the time of return visit was(53.19±11.475)years.After statistical analysis,it was found that the mucosa of reflux esophagitis patients completely healed before and after two times.The change of gastroesophageal flap valve grade was statistically significant(P<0.05).From the data observation,4 cases of fused esophagitis completely healed,and the remaining 38 cases were completely healed by unfused esophagitis.After statistical analysis,it was found that the mucosa of reflux esophagitis patients completely healed before and after two times.The change of gastroesophageal flap valve grade was statistically significant(P<0.05).7.This study counted the number of cases of esophageal hiatal hernia in the complete esophageal mucosal healing of reflux esophagitis patients from the time of initial diagnosis to the return visit.A total of 12 cases of newly diagnosed hiatus hernia were obtained,and 4 cases of recurrent hiatus hernia were included.According to statistical analysis,There was a statistically significant difference in hiatus hernia at the time of initial and return visits(P<0.05).8.Six patients with reflux esophagitis mergered gastric ulcer,74 patients with erosive gastritis,29 patients with duodenal inflammation,and 12 patients with duodenal ulcer,66 patients with esophageal hiatal hernia,reflux esophagitis merged with the above mentioned diseases by two non-parametric Mann-Whitney test analysis,reflux esophagitis and merged gastric ulcer,erosive gastritis,duodenal bulb inflammation,duodenal ulcer were no correlation(P>0.05),associated with hiatus hernia(P<0.05),the logistic regression analysis,hiatus hernia as a risk factor for reflux esophagitis(OR = 5.167).9.In this study,a total of 75 patients underwent rapid urease experiment,and the application of chi-square test showed no correlation with Helicobacter Pylori infection(?2=7.575,P=0.180).Conclusion 1.The severity of reflux esophagitis is related to the gastroesophageal flap valve rating,with the growth of gastroesophageal flap valve grading,endoscopic reflux esophagitis is extended and aggravated.2.As time goes on,LA grading declines.In other words,reflux esophagitis patients with symptomatic treatment shows a trend of improvement.However,as time goes on,gastroesophageal flap valve grading show no changes.Among all the relapsing patients,LA grading and gastroesophageal flap valve grading is the same with the performance of patients with reflux esophagitis for the first time.3.Improvement and Aggravation of reflux esophagitis Patients Are Not Related to gastroesophageal flap valve grading.4.It is easily relapse for the relapsing patients in the same body parts and account for larger proportion than reflux esophagitis occurred in right forearm.5.It is easily relapse for the relapsing patients in the same season and show no regularity;Among the patients who visited the same season,the visiting season was sporadic.6.The gastroesophageal flap valve classification at the initial diagnosis of complete esophageal mucosal healing in reflux esophagitis patients was lower than that of gastroesophageal flap valve at the time of review,patients with esophageal mucosal unfused are more likely to heal esophageal mucosa.7.In patients with reflux esophagitis who had complete esophageal mucosal healing,the combined hiatus hernia at the time of the initial diagnosis was more frequent than the number of hiatus hernia patients at the time of referral.8.Reflux esophagitis has nothing to do with combined gastric ulcer,erosive gastritis,duodenitis and duodenal ulcer,but has something to do with hiatus hernia.Besides,hiatus hernia is a kind of dangerous factor for reflux esophagitis.9.There is no correlation between reflux esophagitis and Helicobacter Pylori. |
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