食管裂孔疝合并反流性食管炎患者的临床特点分析

The Clinical Characteristics of Patients with Esophageal Hiatal Hernia Combined with Reflux Esophagitis

摘要: 目的：本研究旨在深入探讨食管裂孔疝(EHH)合并反流性食管炎(RE)患者的临床特征，并识别相关危险因素，以便为临床治疗提供更有效的指导。方法：采用回顾性分析方法，对2023年1月至6月在青岛大学附属医院内镜中心接受胃镜检查的193例EHH患者进行研究。其中，96例合并RE的EHH患者作为观察组，另外97例未合并RE的EHH患者作为对照组。本研究比较了两组患者在一般情况(包括性别、年龄、吸烟、饮酒、BMI、高血压、糖尿病、精神状态、工作性质)、临床症状、内镜表现、饮食习惯以及幽门螺杆菌(HP)感染情况等方面的差异。结果：体重、BMI和生活习惯：在体重和BMI方面，两组患者表现出显著差异。特别是在合并反流性食管炎(RE)组中，有两种或三种不良饮食习惯的患者比例显著高于未合并RE组。吸烟、焦虑和工作性质：吸烟和焦虑状态在合并RE组中更为普遍，且该组中以脑力劳动者为主，超过了体力劳动者的比例。高血压和糖尿病：高血压和糖尿病在两组之间也显示出显著差异。临床症状：反酸和烧心的症状在合并RE组患者中更为常见。不同级别食管炎患者的特征差异：吸烟：在C级和D级反流性食管炎患者中，吸烟行为的差异达到了显著水平。BMI：A级和B级反流性食管炎患者在BMI上显示出显著差异。性别：D级食管炎与A级和B级食管炎患者在性别分布上存在显著差异。这些结果提供了关于食管裂孔疝合并反流性食管炎患者的重要临床特征和风险因素的见解，对于未来的治疗策略和管理提供了有价值的指导。结论：本研究深入探究了食管裂孔疝合并反流性食管炎患者的核心危险因素，发现关键危险因素：体重、BMI、吸烟、焦虑、工作性质、高血压、糖尿病、反酸与烧心和饮食习惯是食管裂孔疝合并反流性食管炎发展的重要因素。特别是，存在两种或三种不良饮食习惯的患者，其风险显著增加。临床特征：合并反流性食管炎的食管裂孔疝患者中，男性比例高于女性，焦虑症状更常见，且脑力劳动者多于体力劳动者。这些患者更频繁出现反酸和烧心的症状，倾向于有多种不良饮食习惯。不同级别食管炎的差异：吸烟在C级和D级反流性食管炎患者中的影响显著。BMI在A级和B级食管炎患者中是一个关键因素。性别差异在D级食管炎与A级及B级食管炎之间表现出显著的影响。

Abstract: Objective: This study aims to thoroughly investigate the clinical characteristics of patients with Esophageal Hiatal Hernia (EHH)combined with Reflux Esophagitis (RE) and identify relevant risk factors to provide more effective clinical treatment guidance. The method employed is a retrospec-tive analysis of 193 EHH patients who underwent gastroscopy at the Endoscopy Center of Qingdao University Affiliated Hospital from January to June 2023. Among these, 96 patients with combined RE were designated as the observation group, while the remaining 97 without RE were the control group. The study compared differences between the two groups in general conditions (including gender, age, smoking, drinking, BMI, hypertension, diabetes, mental state, and nature of work), clinical symptoms, endoscopic findings, dietary habits, and Helicobacter pylori (HP) infection status. Results: Weight, BMI, and Lifestyle: Significant differences were observed between the two groups in terms of weight and BMI. Notably, in the combined RE group, a significantly higher proportion of patients had two or three unhealthy dietary habits compared to the non-combined RE group. Smoking, Anxiety, and Work Nature: Smoking and anxiety were more prevalent in the combined RE group, where a majority were mental laborers exceeding the proportion of physical laborers. Hy-pertension and Diabetes: Significant differences in hypertension and diabetes were observed be-tween the two groups. Clinical Symptoms: Symptoms of heartburn and acid reflux were more com-mon in the combined RE group. Differences in Esophagitis Levels: Smoking: Significant differences were observed in smoking behavior between levels C and D of reflux esophagitis. BMI: Significant differences in BMI were noted between levels A and B. Gender: Significant gender differences were found between level D and levels A and B of esophagitis. These findings provide insights into the critical clinical characteristics and risk factors of patients with esophageal hiatal hernia combined with reflux esophagitis, offering valuable guidance for future treatment strategies and manage-ment. Conclusion: The study delved into the core risk factors for patients with esophageal hiatal hernia combined with reflux esophagitis, identifying key risk factors: weight, BMI, smoking, anxiety, nature of work, hypertension, diabetes, heartburn, and dietary habits as significant contributors to the disease’s development. Particularly, patients with two or three unhealthy dietary habits faced a significantly increased risk. Clinical Characteristics: In patients with esophageal hiatal hernia com-bined with reflux esophagitis, a higher proportion were male, more prone to anxiety, and predomi-nantly engaged in mental labor. These patients more frequently experienced heartburn and acid reflux symptoms and tended to have multiple unhealthy dietary habits. Differences in Esophagitis Levels: Smoking had a significant impact on levels C and D of reflux esophagitis. BMI was a key fac-tor for levels A and B. Gender differences were significant between level D and levels A and B of esophagitis.