Study On The Influencing Factors Of Detection Rate And Symptoms Of Heterotopic Gastric Mucosa Patch Of The Esophagus

Objective: To investigate whether heterotopic gastric mucosa patch of the esophagus is related to anti-acid,heartburn,pharyngeal foreign body sensation,swallowing discomfort,cough,asthma and other symptoms.To understand the correlation between symptoms and the characteristics of endoscopic lesions.To study the detection rate of the disease and explore the influencing factors of the detection rate.Materials and methods: From November 2016 to September 2018,the number of patients who underwent electronic gastroscopy in our hospital was analyzed retrospectively.the cases were screened according to the inclusion criteria and exclusion criteria.The patients were consulted in detail before gastroscopy.The esophagus was carefully observed by electronic gastroscopy.The number,position,size,shape and color of the lesions in the esophagus were accurately recorded,and the pathological examination was carried out.The gastroscopy operation was performed by two operators.The gastroscopy was performed by ordinary white light and endoscopic narrow band imaging.Some patients were treated with NBI mode to observe the esophagus.Calculation Detection rate of esophageal and gastric mucosal heterosis.Results: After statistics,the total number of cases of electronic gastroscopy in our hospital from July 2016 to May 2018 was a total of 28497 cases.A total of 17090 cases meeting the selection criteria entered the study.A total of 165 cases were diagnosed as heterotopic gastric mucosa patch of the esophagus with a detection rate of 0.97%.In all patients with heterotopic gastric mucosa patch of the esophagus,there were 78 cases of patients with anti-acid symptoms,120 cases of patients with heartburn symptoms,95 cases of pharyngeal foreign body sensation,132 cases with dysphagia symptoms,58 cases of patients with recurrent cough symptoms,and a total of 10 cases of asthma symptoms.The incidence of heartburn was 72.72% in HGM(heterotopic gastric mucosa patch of the esophagus)group and 35.39% in non-HGM group,P value is 0.045,and the difference was statistically significant.In the analysis of the symptoms of swallowing discomfort,the proportion of patients in HGM group and non-HGM group was 80% and 61.90%,respectively.P value is 0.047,and the difference was statistically significant.The difference between the HGM group and the non-HGM group was not statistically significant in terms of sex,average age,anti-acid,pharyngeal foreign body sensation,cough and asthma symptoms.The range of gastric mucosal lesions visible under gastroscopy was between 15 cm and 20 cm from the incisors,and the number of lesion sites from 15 cm to 17 cm away from the incisors was 50,compared with 30.3%.The number of lesions sites from 18 cm to 20 cm away from the incisors was 115,and the proportion was 69.7%.In the process of single lesion analysis,the lesion area of the right wall of esophagus occupies an absolute proportion,accounting for 42.35%.The number of double lesions was 12,and 1 case were in patients with three lesions.There was no statistically significant difference in the symptoms of heartburn and swallowing discomfort in single lesion group and multi-lesion group.There was no statistically significant difference in the symptoms of heartburn and swallowing discomfort in incisors 15cm?17cm group,distance from incisors 18cm?20cm group.There was no statistically significant difference in the symptoms of heartburn and swallowing discomfort in the >1cm group and the long diameter ?1cm group of the lesion.However,the number of swallowing discomfort case in the long diameter >1cm group was 24,the proportion was 96%,the number of cases of swallowing discomfort in the long diameter ?1cm group of the lesion was 108,the proportion was 77.14%,the P value was 0.030,and the difference was statistically significant.The operation of gastroscope and gastroscopic surgeon were the main factors affecting the detection rate of heterotopic gastric mucosa.Compared with the common white light gastroscope group,NBI(narrow band imaging)has a higher detection rate of heterotopia,P value was less than 0.005,and the difference was statistically significant.All 165 patients were confirmed by pathological examination,and the orange lesions in the esophagus showed gastric columnar epithelium.Conclusion: Heterotopic gastric mucosa patch of the esophagus has certain correlations with heartburn and swallowing discomfort.The distribution of single lesion area is mostly in the right wall of esophagus.The ectopic gastric mucosal lesions longer than 1cm are more likely to cause the occurrence of swallowing discomfort.The operation of gastroscope and gastroscopic surgeon were the main factors influencing the detection rate of heterotopic gastric mucosa patch of the esophagus.The detection gastric mucosal ectopic by NBI gastroscopy was significantly higher than that by normal white light gastroscopy.