氩离子凝固术在消化系统疾病中的应用  

Application of argon laser photo-coagulation (APC) in the treatment of digestive diseases

作　　者：贾爱芹[1] 尚瑞莲[1] 孙自勤[1] 陈桂荣[1] 刘晓峰[1] 

机构地区：[1]济南军区总医院消化科,济南250014

出　　处：《解放军医学杂志》2006年第12期1178-1179,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨氩离子凝固术(APC)在消化系统疾病内镜介入治疗中的应用及疗效。方法采用内镜下APC术治疗562例患者(胃肠道息肉393例,疣状胃炎122例,Barret食管5例,消化道出血42例),以观察其对不同疾病的治疗效果。结果350例直径小于5mm的消化道息肉经APC治疗后3个月内复查内镜病变全部消除,治愈率为100%;直径大于5mm广基或亚蒂、细蒂息肉43例,38例于治疗后3个月内复查内镜均无残存病变,黏膜修复好,另5例黑斑息肉综合征经治疗后内镜下表现明显好转;42例消化道出血中41例APC治疗后均未再出血;122例疣状胃炎患者治疗后1个月复查胃镜,116例内镜表现完全恢复正常,治愈率可达95.08%。联合高剂量质子泵抑剂(PPI)治疗5例Barret食管患者,6个月后内镜及病理检查示3例恢复为鳞状上皮,12个月后复查未见复发。结论APC可广泛用于消化道息肉、消化道非食管胃底静脉曲张性出血、Barret食管、疣状胃炎等疾病的内镜介入治疗,尤其对广基(直径小于5mm)扁平息肉、疣状胃炎治愈率高、疗效显著,且简便易行、并发症少,有较高的临床应用价值。Objective To probe into the application of argon laser photo-coagulation （APC） in interventional endoscopic treatment of digestive diseases. Method 62 patients suffering from digestive diseases were treated with interventional endoscopic treatment with the aid of APC, including 393 cases of gastrointestinal polyps, 122 cases of gastritis verrucosa, 5 cases of Barretfs esophageal ulcer and 42 cases of hemorrhage of digestive tract. The effectiveness of the treatment was observed. Result For 350 cases of gastrointestinal polyp, in which the diameter of the polyp was less than 5 mm, the lesions were eliminated when checked by endoscopy 3 months after APC treatment, the curative ratio was 100%. For 43 cases of gastrointestinal polyps, in which the diameter of the polyp was larger than 5 mm, no residual lesions were found in 38 cases, and remarkable improvement was found in another 5 cases of Peutz-Jeghers syndrome. For 122 case of gastritis verrucosa, 116 cases recovered thoroughly, the curative ratio reached 95. 1%. In 42 cases of hemorrhage of digestive tract, no hemorrhage was found in 41 cases after APC treatment. In 5 cases of Barrettts esophageal ulcer treated with APC accompanied by PPIs, squamous cell epithelium was found to have recovered as shown by endoscopy and biopsy 3 months after the treatment, and no recurrence 12 months later. Conclusion APC can be widely used in digestive diseases including gastrointestinal polyps, hemorrhage of digestive tract, Barretfs syndrome, gastritis verrucosa, etc. APC has a special value for the treatment of gastrointestinal polyp when the diameter of the polyp was less than 5 mm, and also gastritis verrucosa.

关 键 词：氩离子凝固术 消化系统疾病 内镜介入治疗 

分 类 号：R454[医药卫生—治疗学] R57[医药卫生—临床医学]