射频消融治疗食管不典型增生的临床研究  

Value of radiofrequency ablation for esophageal dysplasia

作　　者：王强[1] 吴清明[1] 童强[1] 李胜保[1] 张卫国[1] 王小虎[1] 

机构地区：[1]郧阳医学院附属十堰市太和医院消化内科,湖北十堰442000

出　　处：《中国现代医学杂志》2006年第24期3768-3770,共3页China Journal of Modern Medicine

摘　　要：目的探讨内镜染色指示下射频消融术治疗食管不典型增生的疗效和安全性。方法对内镜检查发现食管有可疑病灶的病人用2%碘溶液食管染色后,在染色指示下多点取活检,经病理诊断为不典型增生,超声内镜检查病变局限于黏膜层者,在染色内镜直视下从病灶周围0.3￣0.5cm处开始先射频点灼上下左右四点以标记切除范围,然后自病灶边缘向中心规律的射频消融治疗,功率为35W,每个接触部位治疗时间3、4s,将病灶及周围0.3￣0.5cm以内黏膜及黏膜下层碳化为止。结果45例食管不典型增生(轻度13例、中度17例、重度15例)患者经一次染色内镜下射频消融治疗,随访6周～3年,所有病人痊愈,未发生出血、穿孔并发症。结论射频消融术可作为阻断食管癌变发生发展的首先方法。[Objective] To investigate effectiveness and reliability of radiofrequency ablation for esophageal dysplasia by endoscopic dyeing. [Methods] 65 patients with suspected focus of esophagus were enrolled during endoscopic examination. The samples were spraied with 2% Lugol′s iodine, instructed by endoscopic dyeing, pathological examination were taken from the focuses by multiple biopsies. If the samde was esophageal dysplasia by pathological examination, then radiofrequency ablation was performed till the mucosa and submucosa of focus and 0.3~0.5 cm focus-free margin were carbonized, the follow-up ranged from 6 weeks to 7 years. [Results] 45 cases of esophageal dysplasia (13 cases of high-grade dysplasia, 17 cases of mild-grade dysplasia, 15 cases of light-grade dysplasia) with treatment of radiofrequency ablation fully recovered and didn′t suffer from complication. [Conclusions] Radiofrequency ablation instructed by endoscopic dyeing is a convenient, effective and safe therapy for esophageal dysplasia

关 键 词：食管不典型增生 染色内镜检查 射频消融术 

分 类 号：R571[医药卫生—消化系统]