一例Barrett食管患者的循证治疗  

Evidence-Based Treatment for a Patient with Barrett's Esophagus

作　　者：林丹丹[1] 董卫国[1] 吕晓光[1] 刘启胜[1] 田珍[1] 施华秀[1] 

机构地区：[1]武汉大学人民医院消化内科,武汉430060

出　　处：《中国循证医学杂志》2012年第4期484-488,共5页Chinese Journal of Evidence-based Medicine

摘　　要：目的借助循证医学方法为1例成年男性Barrett食管患者确定治疗方案。方法在充分评估患者情况后,提出临床问题,从Cochrane图书馆(2009年第3期)、PubMed(1995～2010)和SCIE(1995～2010)上检索Barrett食管治疗的系统评价和RCT。根据当前最好证据结果及病人意愿为患者制定治疗目标和治疗方案。结果共检出与不同问题相关的RCT 21篇,系统评价/Meta分析6篇。通过对检索结果进行分析并结合患者意愿,为患者制定了合理的治疗方案:改善生活习惯,内镜下行氩等离子凝固术(APC)结合抑酸药物(奥美拉唑,40 mg,bid)治疗6周。3个月后内镜复查,患者症状减轻,病灶消失。又经过12个月随访证实,患者满意该方案适合该患者。结论采用循证治疗方法,为初诊男性Barrett食管患者确定合理的治疗目标和方案,能有效减轻患者症状,提高生活质量。Objective To make an individualized treatment plan for a newly diagnosed Barrett esophagus patient by means of evidence-based medicine.Methods After the clinical problems were put forward,both the systematic reviews and randomized controlled trials（RCTs） were collected from The Cochrane Library（Issue 3,2009） and PubMed（1995 to 2010） and SCIE（1995 to 2010）.The treatment protocol was made by combining the evidence and the preference of patient.Results A total of 21 RCTs and 6 systematic reviews（meta-analyses） were identified.A rational treatment plan was made upon a serious evaluation and patient＇s preferences： improving the lifestyle and adopting the APC therapy combined with acid-suppressive drugs（Omeprazole,40 mg,bid） for six weeks.Three months later,the endoscope reexamination showed the patient was much better.After another twelve-month follow-up,the plan proved to be optimal.Conclusion In accordance with the evidence-based methods,the rational treatment plan made for a diagnosed Barrett esophagus male can effectively relieve symptoms and improve quality of life.

关 键 词：BARRETT食管 循证治疗 随机对照试验 系统评价 

分 类 号：R571[医药卫生—消化系统]