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女子吃啥吐啥持续呕吐3年 瘦如纸片体重仅30公斤

2017-08-18 10:58:05   中国青年网

广西新闻网-当代生活报讯 8月16日,28岁的何女士高兴地从广西民族医院出院了,困扰她3年的频繁呕吐症状终于好了。而在一个多星期前,到广西民族医院消化内科求诊的何女士将医护人员吓了一跳,当时身高153cm的何女士被疾病折磨得瘦骨嶙峋,如同纸片一般,体重只有30公斤。

原来,何女士持续呕吐了3年,吃啥吐啥,一吃就吐,受尽了折磨,但却不知道得了什么病。据何女士自述,3年前她怀孕初期开始频繁呕吐,刚开始以为是妊娠常见反应,没有在意。然而整个孕期何女士都没有停止呕吐,米饭、肉类蔬菜和水果等一吃就吐,只能靠喝粥、喝汤和牛奶等流质食物维持身体所需。生下儿子后何女士还是吐,但因为照顾孩子没有时间,也不在意,一拖又是两年。

近几个月何女士连喝水都会引起呕吐,整个人消瘦了近20斤,脸色苍白,浑身无力,爱人带她去南宁某医院就诊。当时经医院胃镜检查发现,其食管内残留很多食物残渣,食管下段明显扩张,到食管与胃的结合部(贲门)胃镜根本进不去,考虑贲门失弛缓症,合并中度贫血,鉴于该院医疗资源有限,于是何女士来到广西民族医院消化内科继续诊疗。

广西民族医院消化内科罗显克主任在了解何女士的情况后,采用食道钡餐检查,检查提示其食管末端明显狭窄(呈“鸟嘴”状),确诊为贲门失弛缓症。罗主任告诉何女士,贲门位于食管与胃的连接处,贲门失弛缓症是一种吞咽后食管无蠕动、贲门括约肌弛缓不良的疾病。临床上表现为进食困难,体重减轻,餐后返食,夜间呛咳以及胸骨后不适或疼痛,患者可因长期咽下困难造成营养不良,而何女士一直无法正常饮食就是由此症引起的。

据介绍,迄今为止,贲门失弛缓症的病因仍不明确。一般认为是神经肌肉功能障碍所致,其发病与食管肌层内神经节细胞变性、减少或缺乏以及副交感神经分布缺陷有关。神经节细胞退变的同时,常伴有淋巴细胞浸润的炎症表现,或许病因与感染、免疫因素有关。

该病较为少见,发生率国外报告每10万人中仅约0.5~1人,多见于成年人。虽然该病少见,但还是有办法治疗的。罗主任建议何女士住院进行经口内镜下肌切开术(POEM术)治疗。8月9日,消化内科罗显克主任在广西民族医院胃镜室为何女士行POEM术,术程顺利,历时1小时即完成手术。术后第3天开放饮食后,何女士进食流质食物后不吐了,术后1周未见明显并发症,呕吐症状好转。

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