氩离子凝固术联合药物治疗Barrett食管的前瞻性研究  

Prospective study on argon plasma coagulation combined with drugs for the treatment of Barrett's esophagus

作　　者：王雯[1] 刘化芳[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,福州市350025

出　　处：《中华实用诊断与治疗杂志》2009年第6期538-540,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：南京军区医药卫生科研重点项目(07Z035)

摘　　要：目的:研究氩离子凝固术联合药物治疗对Barrett食管的疗效及安全性。方法:经胃镜及病理组织活检确诊的Barrett食管患者113例,随机分为3组,Ⅰ组23例为对照组,未给予治疗;Ⅱ组33例给予口服奥美拉唑;Ⅲ组48例行氩离子凝固术后并口服药物(同Ⅱ组)维持,3个月后复查,若发现有残留Barrett食管,再次行氩离子凝固术治疗1次。所有患者治疗1年,并在治疗6个月及12个月时复查内镜并行病理组织活检,比较3组治疗前、后临床症状、胃镜检查及病理组织活检结果。结果:Ⅰ组临床症状无明显改变,Ⅱ组与Ⅲ组均较治疗前明显改善。Ⅰ组与Ⅱ组Barrett食管未见明显变化。Ⅲ组能使89.6%的Barrett食管达到胃镜下完全消除,1年后复发率为25.6%,至随访结束时,完全缓解Barrett食管占治疗的66.7%。结论:氩离子凝固术联合药物治疗既可改善Barrett食管的症状,也可消除Barrett食管,但复发率较高。Objective To investigate the effect and safety of argon plasma coagulation combined with drugs on Barrett＇s esophagus. Methods One hundred and thirteen patients with Barrett＇s esophagus diagnosed with endoscopy and biopsy were randomly divided into 3 groups. Group 1 served as control group, group 2 was treated with continuous omeprazole and group 3 was treated with argon plasma coagulation combined with the same drug. If there was residual Barrett＇s esophagus after 3 months, argon plasma coagulation was reperformed. All the patients were treated for 1 year and received the review of endoscopy and biopsy 6 and 12 months later. The clinical symptoms and the results of the endoscopy and biopsy were compared in three groups. Results Clinical symptoms did not change in group 1, while significantly ameliorated in the other 2 groups. There was no statistic change of Barrett＇s esophagus between group 1 and 2. In group 3, 89.6% of patients achieved the complete macroscopic clearance of Barrett＇s esophagus, and the recurrence rate of Barrett＇s esophagus was 25. 6% one year later. At the end of follow-up, 66.7 % of the treated patients had complete remission of Barrett＇s esophagus. ConcluSion The treatment of argon plasma coagulation combined with drugs can ameliorate the symptoms of Barrett＇s esophagus and achieve macroscopic clearance, but the recurrence rate is high.

关 键 词：BARRETT食管 氩离子凝固术 复发 

分 类 号：R571[医药卫生—消化系统]