窄带成像辅助氩等离子凝固术治疗Barrett食管的临床应用  

Narrow band imaging assisted argon plasma coagulation for Barrett＇s esophagus

作　　者：谢明[1] 廖晓宏[2] 戴绍军[1] 汤绍迁[1] 陈海燕[1] 杨元胜[1] 王静[2] 

机构地区：[1]华中科技大同济医学院附属荆州医院消化科,434020 [2]华中科技大同济医学院消化内镜中心,434020

出　　处：《中华消化内镜杂志》2010年第5期252-255,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的 探讨内镜窄带成像技术（NBI）辅助氩等离子凝固术（APC）治疗Barrett食管的价值.方法 86例经内镜检查及病理诊断的Barrett食管,分别在普通模式及NBI模式下观察食管黏膜,以NBI放大观察病变的腺管开口形态及毛细血管结构形态.对所有NBI阳性部位均取活检,并以病理结果为标准,随机分为两组.Barrett食管的诊断时都用NBI内镜,治疗组42例,在NBI内镜辅助下进行APC治疗,内镜进入食管后,把APC探针经活检钳孔道伸出镜外1 cm,定位于需治疗黏膜1～2 cm处,以保证APC安全使用;对照组44例,在普通内镜下行APC治疗.于第3、6个月对两组进行内镜及病理随访.结果 两组治疗后第3、6个月从内镜、病理随访的有效率来看,治疗组与对照组的差异无统计学意义（P〉0.05）.结论 NBI辅助APC治疗Barrett食管能有效逆转Barrett上皮,并提高高级别上皮瘤样变的检出率,减少Barrett上皮逆转的治疗次数,且能部分缓解功能性胃肠病的症状,治疗安全.Objective To evaluate narrow band imaging （NBI） assisted argon plasma coagulation （APC） in treatment of Barrett＇s esophagus （BE）. Methods Suspected BE lesion was observed under white light, NBI and magnification, biopsies were taken at the site with characteristic pit pattern and capillary architecture of BE. A total of 86 patients with pathologically confirmed BE were randomly divided into NBI group （n= 42） to receive APC under NBI, or control group （n= 44） to receive APC under whit light. For APC procedure, the probe was inserted through biopsy channel to reach 1 cm beyond the endoscope tip, and was located 1-2 cm from the lesion to assure safe use. All patients were followed up with endoscopy and biopsy at 3 and 6 months after APC, respectively. Results There was no significant difference between 2 groups in effective rate of BE mucosal eradication at 3 and 6 months after APC procedure （P 〉 0.05）. Conclusion NBI assisted APC is safe and effective in eradication of BE epithelium, in reducing procedure time and in relieving of functional gastrointestinal symptoms related with BE.

关 键 词：BARRETT食管 内窥镜检查 窄带成像技术 氩等离子凝固术 

分 类 号：R571[医药卫生—消化系统]