内镜下氩离子凝固术治疗食管低级别上皮内瘤变的临床研究  

Clinial Study of Endoscopic Argon Plasma Coagulation for Treatment of Esophageal Low Grade Intraepithelial Neoplasia

作　　者：陈思杰 邹清云 黄中华 陈伟 薛鹏星 谢淑芳 

机构地区：[1]福建省莆田市第一医院消化内科,351100

出　　处：《中国消化内镜》2009年第4期1-4,共4页Digestive Disease and Endoscopy

基　　金：莆田市科技计划项目(NO.2008Z301)

摘　　要：目的探讨内镜染色指示下氩离子凝固术治疗食管鳞状上皮低级别上皮内瘤变的疗效和安全性。方法对内镜检查发现食管有可疑病灶的病人用1.2%复方碘溶液食管染色后,在染色指示下多点取活检,经病理诊断为食管鳞状上皮低级别上皮内瘤变,在染色内镜直视下从病灶周围0.3～0.5cm处开始先氩离子凝固点灼上下左右四点以标记切除范围,然后将探头在病灶的最远端到最近端来回或平行移动进行凝固治疗,至治疗区域黏膜完全呈黑褐色或棕黑色,病灶完全破坏为止。结果36例食管鳞状上皮低级别上皮内瘤变患者经1～3次染色内镜下氩离子凝固治疗,随访6周～3年,3例失访,其余病人痊愈,未发生严重并发症。结论内镜下染色指引下氩离子凝固术可作为阻断食管鳞状上皮低级别上皮内瘤变发展的有效安全的方法。Objective： To investigate effectiveness and reliability of argon plasma coagulation for esophageal low grade intraepithelial neoplasia by endoscopic dyeing. Methods： 36 patients with suspected focus of esophagus were enrolled during endoscopic examination.The samples were spraied with 1.2% Lugol＇s iodine, instructed by endoscopic dyeing, pathological examination were taken from the focuses by multiple biopsies. The cases with esophageal low grade intraepithelial neoplasia by pathological examination were treated with argon plasma coagulation 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 3 years. Results： 33 of 36 cases of esophageal low grade intraepithelial neoplasia with treatment of argon plasma coagulation fully recovered and didn＇t suffer from serious complication. Conclusion： Endoscopic argon plasma coagulation instructed by endoscopic dyeing is a convenient, effective and safe therapy for esophageal low grade intraepithelial neoplasia.

关 键 词：食管 低级别上皮内瘤变 氩离子凝固术 

分 类 号：R573[医药卫生—消化系统] R573.2[医药卫生—内科学]