放大染色胃镜下氩气刀治疗胃黏膜隆起糜烂的临床研究  

Magnifying chromogastroscopic plasma coagulation in treatment of gastric protrusive erosion

作　　者：唐少波[1] 袁海锋[1] 奚锦要[1] 王美丽[1] 

机构地区：[1]广西中医学院附属瑞康医院消化内科,广西南宁530011

出　　处：《右江民族医学院学报》2008年第4期542-543,共2页Journal of Youjiang Medical University for Nationalities

摘　　要：目的探讨放大染色胃镜下氩气刀（APC）在治疗胃黏膜隆起糜烂的临床效果及价值。方法应用放大内镜结合美蓝染色，对胃炎伴隆起糜烂的患者进行胃黏膜细微结构形态学观察，将胃小凹为D、E和F型的80例患者纳入治疗，应用APC800型氩气刀对病灶进行治疗，观察治疗的临床结果及价值，并干治疗后1月放大染色胃镜复查随访疗效。结果APC治疗胃黏膜隆起糜烂病灶384处，每个患者平均4．3处，1个月后复查随访，73例（91．25％）临床症状明显改善，经放大染色胃镜复查发现，68例（85％）患者病灶基本消除，原病灶处均覆盖新生的黏膜上皮及肉芽组织，胃小凹为A、B型的患者57例（83．82％），胃小凹为C型的患者11例（16．18％），7例（8．75％）患者仍有症状，镜下观察胃小凹仍为D、E和F型，需要再次APC治疗。APC治疗后部分患者出现上腹部隐痛、腹胀等症状，2～3天后可消失，并无其它严重并发症发生。结论放大染色胃镜能准确识别胃小凹的形态，使APC更能准确地治疗胃黏膜隆起糜烂病灶，治疗效果肯定，操作简便。Objective To evaluate the clinical efficacy and value of magnifying chromogastroscopic plasma coagulation （APC） in treatment of gastric protrusive erosion. Methods Magni lying endoscope in combination with methylene blue staining were used to observe the micro- structures of gastric mucosa in patients with gastric protrusive erosion. 80 cases with gastric pit types D, E and F were treated with APC- 9800. Observed the clinical results and value of APC. One month after treatment, the patients were once more observed under magnifying chromogastroscopy and evaluated clinical effects. Results APC had treated 384 loci of gastric protrusive erosion, with an average of 4.3 loci in each patient. A one-month follow-up showed that 73 cases （91.25%） with ameliorated symptoms, while 68 cases （85%） of them were with good results （free symptoms）, the original loci were covered with new mucosal epithelium and granulation tissues. 57 patients （83.82%） were with gastric pit types A and B, 11 cases （16.18%） with gastric pit type C, 7 cases （8.75%） of the patients still had symptoms. The patients, who still had gastric pit types D, E and F with repeatedly magnifying chromogastroscopy, needed to be treated by A_PC again. Part of patients after receiving treatment of A_PC had upper abdominal hidden pain and abdominal distention, and so on. But these symptoms disappeared after 2 or 3 days. No other serious complication occurred. Conclusion Magnifying chromogastroscopy can accurately identify the micro- structures and shapes of gastric pit, which makes it easy, accurate and effective to treat gastric protrusive erosion.

关 键 词：胃黏膜 胃小凹 胃炎 氩气刀 胃镜检查 

分 类 号：R573.32[医药卫生—消化系统] R443.7[医药卫生—内科学]