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[¹«´äÅä·Ð - À§½Äµµ¿ª·ùÁúȯ 004. ¹ßÀûµµ mucosal breakÀΰ¡?]

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Á¶±âÀ§¾Ï ³»½Ã°æ Ä¡·á ÈÄ °æ°ú°üÂû ÁßÀΠȯÀÚÀÇ ½Äµµ ¼Ò°ßÀÔ´Ï´Ù. ¿©·¯ºÐÀº ¾î¶»°Ô ±â¼úÇϽðڽÀ´Ï±î?


[2015-1-23] 2015³â 1¿ù 15ÀÏ À§½Äµµ¿ª·ùÁúȯ ȯÀÚ ÇѺÐÀÇ ³»½Ã°æ »çÁø¿¡ ´ëÇÑ ÀÇ°ßÀ» ¿©Âà ¹Ù ÀÖ½À´Ï´Ù.

ÇÑ µ¶ÀÚÀÇ ´äº¯À» ¼Ò°³ÇÕ´Ï´Ù. ¼ÖÁ÷ÇÑ ´äº¯À» ÁֽŠ¾Öµ¶ÀÚ ¼±»ý´Ô²² °¨»çµå¸³´Ï´Ù.

"Àú´Â Reflux esophagitis, LA classification-A·Î ±â¼úÇÏ°Ú½À´Ï´Ù. Z-line »óºÎ·Î ÀϹÝÀûÀ¸·Î º¸ÀÌ´Â mucosa break´Â ¾Æ´ÏÁö¸¸ ´Þ¸® ´Ù¸¥ Ç¥ÇöÀ» Çϱ⿡´Â ´õ È¥¶õÀÌ ¿Ã °ÍÀ¸·Î º¸À̱⠶§¹®ÀÔ´Ï´Ù."

ÀÌ ºÐÀÇ °í¹ÎÀº 3½Ã ¹æÇâÀÇ ºÓÀº »ï°¢Çü ¸ð¾çÀÇ º¯È­°¡ erosionÀº ¾Æ´ÏÁö¸¸ ±×·¸´Ù°í Á¤»óÀ̶ó°í ÇÒ ¼öµµ ¾øÀ¸´Ï (ºñ·Ï Á¤È®ÇÑ Ç¥ÇöÀº ¾Æ´ÏÁö¸¸) mucosal break·Î °£ÁÖÇÏ¿© LA classification A ¿ª·ù¼º½Äµµ¿°À¸·Î Áø´ÜÇÏ°Ú´Ù´Â °ÍÀÔ´Ï´Ù.

2010³â 11¿ù 24ÀÏ EndoTODAY¿¡¼­ ¸»¾¸µå¸° ¹Ù¿Í °°ÀÌ Á¡¸·»óÇØ(mucosal break)ÀÇ Á¤ÀÇ´Â "an area of slough or erythema clearly demarcated from the adjacent normal appearing mucosa"ÀÔ´Ï´Ù. Áï mucosal break´Â erythema, erosion, ulcer¸¦ ¸ðµÎ Æ÷ÇÔÇÏ´Â ¸»ÀÔ´Ï´Ù. ±×·±µ¥ ¸¹Àº ºÐµéÀÌ erosion°ú ulcer¸¸À» Á¡¸·»óÇØ·Î »ý°¢ÇÕ´Ï´Ù. Erythema±îÁö Á¡¸·»óÇØ·Î ºÎ¸£´Â °Í¿¡´Â °ÅºÎ°¨À» °¡Áö°í °è½Å °Í °°½À´Ï´Ù.

À§½Äµµ¿ª·ùÁúȯ ȯÀÚµéÀÇ ³»½Ã°æ »çÁøÀ» º¸¸é À̹ø Áõ·Ê¿Í °°ÀÌ erosionÀ̶ó°í ºÎ¸£±â ¾î·Á¿î erythema¸¦ ¸¹ÀÌ º¸°Ô µË´Ï´Ù. Àú´Â ÀÌ ¶ÇÇÑ mucosa break·Î ºÎ¸¦ °ÍÀ» ±ÇÀåÇÕ´Ï´Ù. Á¤ÀÇ¿¡ µû¸£´Â °ÍÀ̱⵵ Çϱ¸¿ä. µû¶ó¼­ Àú´Â ¾Æ·¡¿Í °°ÀÌ ±â¼úÇÏ°í Áø´ÜÇÏ°Ú½À´Ï´Ù. Áï ¹ßÀûµµ mucosal break¶ó´Â ÀÔÀåÀÔ´Ï´Ù. °úÀ×Áø´ÜÀÇ À§ÇèÀº ÀÖÁö¸¸ ÀÏ´Ü Á¤ÀÇ¿¡ µû¸¥ ¸í¸í¹ýÀÔ´Ï´Ù.

"Squamocolumnar junction Á÷»ó¹æ¿¡ ³ôÀÌ 5 mm ¹Ì¸¸ÀÇ »ï°¢Çü ¹ßÀûºÎ°¡ ÀÖ¾î LA classification group A ¿ª·ù¼º ½Äµµ¿°À¸·Î Áø´ÜÇÔ ."


[2015-1-26. ÀÌÁØÇà] 2015³â 1¿ù 15ÀÏ À§½Äµµ¿ª·ùÁúȯ ȯÀÚ ÇѺÐÀÇ ³»½Ã°æ »çÁø¿¡ ´ëÇÑ ÀÇ°ßÀ» ¿©Âà ¹Ù ÀÖ½À´Ï´Ù.


Á¶±âÀ§¾Ï ³»½Ã°æ Ä¡·á ÈÄ °æ°ú°üÂû ÁßÀΠȯÀÚÀÇ ½Äµµ ¼Ò°ßÀÔ´Ï´Ù. ¿©·¯ºÐÀº ¾î¶»°Ô ±â¼úÇϽðڽÀ´Ï±î?


ÇÑ ¾Öµ¶ÀÚ²²¼­ LA-C·Î ´ë´äÇÏ½Ã¾î ¾Æ·¡¿Í °°Àº ´äº¯À» µå·È½À´Ï´Ù.

"Confluent mucosal break´Â ½Äµµ ÁÖ¸§À» µû¶ó ¸î °³ÀÇ mucosal break°¡ ÀÖ°í ¾Æ·¡¿¡¼­ ¸¸³ª´Â °ÍÀ» ¸»ÇÕ´Ï´Ù. µû¶ó¼­ ÀÌ °æ¿ì´Â »ï°¢Çü ¸ð¾çÀÇ non confluent erosionÀÔ´Ï´Ù. LA A·Î ºÎ¸£¸é ´õ ÁÁ°Ú½À´Ï´Ù. ¾Æ·¡ ¸µÅ©¿Í ±× ¾ÕµÚ¸¦ »ìÆìºÁ Áֽøé Âü°í°¡ µÉ °Í °°½À´Ï´Ù. °¨»çÇÕ´Ï´Ù.
http://endotoday.com/endotoday/20101130.html

À§ ´äº¯¿¡ ´ëÇÏ¿© ¾Öµ¶ÀÚ²²¼­ ¾Æ·¡¿Í °°Àº ¸ÞÀÏÀ» Áּ̽À´Ï´Ù. °¨»çÇÕ´Ï´Ù.

ÀÚ¼¼ÇÑ ´äº¯¿¡ °¨»çµå¸³´Ï´Ù. Àú´Â LA classification Á¤ÀÇ¿¡¼­ º¸´Ï±î Á¡¸·¼Õ»óÀÌ 2°³ÀÌ»óÀÇ Á¡¸·ÁÖ¸§À¸·Î ¿¬¼ÓÇØ ÆÛÁ®ÀÖÁö¸¸ ÀüÁÖ¼ºÀÌ ¾Æ´Ñ°ÍÀÌ "C" ·Î µÇÀ־ ÇϳªÀÇ mucosal break´õ¶óµµ »ï°¢Çü ¸ð¾çÀ¸·Î ³Ð°Ô ÀÖÀ¸¸é Á¤ÀÇ»óÀ¸·Î´Â LA-CÀÎÁÙ·Î Âø°¢Çß¾ú½À´Ï´Ù. ±×·±µ¥ confluent mucosak breakÀÇ ¶æÀÌ ¸î°³ÀÇ mucosal breakµéÀÌ ÀÖ´Ù°¡ ¾Æ·¡¿¡¼­ ÇÕ·ùÇÑ´Ù´Â Àǹ̿´±º¿ä. È®½ÇÈ÷ ¾Ë¾Ò½À´Ï´Ù.


[2015-1-27. ¾Öµ¶ÀÚ ÆíÁö]

Erythema¸¦ mucosal break·Î ÁÖ¾î¾ß ÇÒÁö ¸»Áö¿¡ ´ëÇØ °í¹ÎÀ» Çß¾ú´Âµ¥ ¶Ñ·ÇÇÏÁö ¾Ê´Ù´Â ÀÌÀ¯·Î ¸ðµÎ minimal change¿¡ ³Ö¾ú¾ú½À´Ï´Ù. ¼±»ý´Ô ¸»´ë·Î ´ëºÎºÐÀÇ minimal change¸¦ Áø´Ü¸í¿¡ ³ÖÁö¾Ê°í NERD·Î ÆÇÁ¤ÇÒ ¶§ erythema¸¦ mucosal break·Î ÁÖ°Ô µÇ¸é ¾î´À Á¤µµ °³³ä Á¤¸®°¡ µÉ °Í °°½À´Ï´Ù.


[À§½Äµµ¿ª·ùÁúȯ °ø°³°­Á µ¿¿µ»ó]


[References]

1) EndoTODAY ¹«´äÅä·Ð - À§½Äµµ¿ª·ùÁúȯ

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2015-1-4)