锐利的His角是胃食管阀瓣形态完整的保障,His角是指膨隆延伸的胃底大弯侧在贲门部与食管末端所形成的角度,在上消化道造影检查中可以直观的观察His角的形态。胃镜下翻转镜身可见贲门部移行处有一半圆形黏膜紧密包裹镜根,起活瓣作用,当胃内压力增高时,活瓣紧闭,防止胃内容物反流入食管,此活瓣即为GEFV。
国际推荐通过Hill分级评估GEFV的屏障作用,根据GEFV形态将其分为四级。文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
I级:胃底大弯侧皱襞膨隆,与小弯侧黏膜共同紧密包绕镜根。文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
II级:组织皱襞略松弛,紧密程度不如I级且受呼吸运动影响;文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
III级:组织皱襞已不明显,无法识别半月体的皱襞,更无法与小弯侧黏膜紧密包绕镜根;文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
IV级:常伴有不同程度的食管裂孔疝,镜身通过食管下段时阻力明显减小。文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html
文章源自青年医生博客(youngdoctor.cn)青年医生-https://youngdoctor.cn/2021/495.html