内镜染色指示下射频治疗食管不典型增生的研究  

The Value of Radiofrequency Ablation for Esophageal Dysplasia by Endoscopic Dyeing

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

机构地区：[1]郧阳医学院附属太和医院消化内科,十堰442000

出　　处：《临床消化病杂志》2007年第3期155-156,共2页Chinese Journal of Clinical Gastroenterology

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4点以标记切除范围，然后自病灶边缘向中心规律地射频消融治疗，功率为35W。每个接触部位治疗时间3～4s，使病灶及周围0．3～0．5cm以内黏膜及黏膜下层碳化为止。结果 65例食管不典型增生（轻度18例，中度31例，重度16例）患者经1次染色内镜下射频消融治疗，随访6周～7年，所有病人痊愈，未发生出血、穿孔等并发症。结论 射频消融术可作为阻断食管癌变发生发展的首选方法。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% Lngol＇ s iodine, instructed by endoscopic dyeing, pathological examination were taken from the focuses by multiple biopsies. The cases with esophageal dysplasia by pathological examination were treated with radiofrequency ablation 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 65 cases of esophageal dysplasia（ 16 cases of high-grade dysplasia,31cases of mild-grade dysplasia, 18 cases of light-grade dysplasia with treatment of radiofrequeney ablation fully recovered and didn＇ t suffer from complication. Conclusion Radiofrequeney 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：R735.1[医药卫生—肿瘤]