Barrett食管75例临床治疗观察  

Clinical effect of different treatment on 75 patients with Barrett's esophagus

作　　者：李达周[1] 王雯[1] 张志坚[1] 林克荣[1] 朱金照[1] 文晓冬[1] 吴秋萍[1] 

机构地区：[1]南京军区福州总医院消化内科,福州350025

出　　处：《临床内科杂志》2007年第8期521-523,共3页Journal of Clinical Internal Medicine

基　　金：福建省青年科技人才创新项目(项目编号:2002J059)

摘　　要：目的研究不同方法治疗Barrett食管(BE)患者的疗效,探索各种治疗方法产生效果的可能机制,筛选出合理有效、实用的Barrett食管治疗方案。方法经胃镜及活检确诊的Barrett食管患者75例,随机分为5组,对照组(A组):未给予治疗;抑酸药组(B组):口服奥美拉唑20 mg,2次/天;胆汁吸附剂组(C组):口服铝碳酸镁1000 mg,每日3次;抑酸药+胆汁吸附剂组(D组):口服奥美拉唑20 mg,2次/天;口服铝碳酸镁1000 mg,3次/天;氩气凝固术(APC)+抑酸药及胆汁吸附剂组(E组):行内镜下氩气凝固术治疗,之后口服奥美拉唑20 mg,2次/天,口服铝碳酸镁1000mg,3次/天。各组均治疗3个月。治疗前、治疗后1个月及3个月后观察临床症状及内镜下表现。结果各治疗组的临床症状均较治疗前明显改善,与对照组比较均有显著性差异(P<0.05);各治疗组比较,症状缓解率无明显差异(P>0.05)。对照组和单纯药物治疗组的Barrett食管黏膜均未见明显缩小,E组能使91.3%的Barrett食管患者Barrett食管黏膜消除。结论抑酸药和(或)胆汁吸附剂不能使Barrett食管逆转,但可消除临床症状;APC+抑酸药及胆汁吸附剂方案可以消除症状,也可消除Barrett食管黏膜,安全性好,是治疗Barrett食管的一种合理可行、有效实用的方法。Objective To investigate the effect of different treatment on Barrett＇ s esophagus （BE） and to explore the mechanism of therapeutic regimen in the Barrett＇ s epithelium before and after treatment,five therapeutic regimen were adopted to treat patients of BE in order to select the most effective one. Methods 75 patients with BE were diagnosed by endoscopy and biopsy. All patients were randomly divided into five groups：group A （control group） ;group B （Omeprazole 20mg, bid, po） ;group C （Hydrotaleite 1000mg, tid, po） ; group D （ Omeprazole 20mg, bid, po and Hydrotaleite 1000mg, tid, po） ; group E （ Omeprazole 20mg, bid, po and Hydrotaleite 1000mg, tid, po after argon plasma coagulation）. All patients were treated for three months. Specimens of esophageal tissue were collected and clinical effect was observed by endoscopy before and 1-month and,3-month after treatment. Results The symptoms of patients in treatment groups were significantly relieved when compared to those ingroup A （P 〈 0.05 ）. There were no significant differences in relieving clinical symptom in group B, C, D and E （ P 〉 0.05 ）. Barrett＇ s esophagus didn＇ t improve significantly in group B, C, and D by endoscopy. BE was eliminated in 91.3% patients in group E. Conclusions Omeprazole and/or Hydrotalcite can＇ t eradicate BE, but they can relieve clinical symptom. Argon plasma coagulation combined with Omeprazole and Hydrotalcite is a effective ,safe and promising therapeutic regimen against BE.

关 键 词：BARRETT食管 氩气凝固术 治疗 

分 类 号：R735.1[医药卫生—肿瘤]