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有关类风湿性关节炎的上消化道或食管病变,前人曾有记述,但迄今未发现食管之类风湿性狭窄。作者报导一例。患者为49岁妇女。19岁起罹患类风湿性关节炎。近2年来发生咽下困难,经扩张治疗无效,仅能进流食。入院时手、膝及踝关节均有晚期炎症病变。血管、神经无明显类风湿体征。血红蛋白9.6克。绵羊细胞凝集试验阳性(滴定效价1/32)。玻片试验阳性。抗核因子试验未作。钡餐检查显示主动脉弓水平有3厘米长的狭窄区,其余部分正常,未见裂孔疝。食管镜检证实食管严重狭窄,并有粘膜溃疡及腐肉形成。横膈上5厘米电极隔夜记录的pH值否定了反酸。鉴于扩张困难、患者年龄及营养状况欠佳,决定施行食管全切食管胃吻合术。切
There are descriptions of upper gastrointestinal or esophageal lesions related to rheumatoid arthritis, but as yet no rheumatic stenosis of the esophagus has been found. The author reports an example. The patient is 49 years old. 19-year-old suffering from rheumatoid arthritis. In the past two years, swallowing difficulties, the expansion of treatment is invalid, only into the flow of food. Admission hand, knee and ankle have advanced inflammatory lesions. Blood vessels, nerves no obvious signs of rheumatoid. Hemoglobin 9.6 grams. Sheep cell agglutination test was positive (titration titer 1/32). Slides test positive. Anti-nuclear factor test was not made. Barium meal examination showed aortic arch level 3 cm long stenosis, the rest of the normal, no hiatal hernia. Esophagoscopy confirmed severe esophageal stricture, and mucosal ulcers and carrion formation. The pH recorded on the 5 cm electrode overnight on the diaphragm negates acid reflux. In view of the difficulty of expansion, the patient’s age and poor nutritional status, decided to implement esophageal total esophageal anastomosis. cut