98例Barrett食管临床及内镜下表现与治疗分析  

98 cases of clinical and endoscopic manifestations and treatment of barrett esophagus

作　　者：孙锟[1] 朱道明[1] 肖贤珍[1] 

机构地区：[1]安徽医科大学附属巢湖医院消化内科,安徽巢湖238000

出　　处：《黑龙江医药科学》2012年第6期18-20,共3页Heilongjiang Medicine and Pharmacy

摘　　要：目的:研究Barrett食管(BE)的临床特点和内镜下表现及其治疗手段。方法:普通人群行电子内镜检查,对98例确诊为Barrett食管的患者分析其内镜下的表现,病理分型及治疗。结果:内镜表现:98例患者中,全周型47例,占47.96%,舌型20例,占20.41%,岛型13例,占13.26%,岛型和舌型混合18例,占18.37%。临床表现:多数患者无明显症状,一部分表现为反酸、嗳气、胸骨后烧灼感或吞咽不适感,上述患者多合并反流性食管炎或胆汁反流性胃炎。治疗:①饮食调整:饮食忌酸性、过烫、过硬、过辣,睡前少进食;②药物治疗:抑酸、抗反流、保护胃黏膜等对症处理;③对于单个较大或多发岛状病灶或BE的长度>15mm者行APC(氩离子凝固术)治疗或多次治疗;④对确诊食管腺癌或伴重度不典型增生者建议手术。结论:内镜随访检查对Barrett食管确诊及早期食管腺癌的检出有着重要的意义。Objective： To study the clinical features and endoscopic features and treatment method of Bar- rett esophagus （BE）. Methods： After an electronic endoscopy to the general population, 98 confirmed cases of Barrett patients were examined with endoscopic manifestations of esophageal, pathologic classification and treat- ment of Barrett esophagus. Results： Endoscopic findings： In 98 patients, the entire week Barrett esophagus were 47 cases, accounting for 47. 96%; Tongue type 20 cases, accounting for 20.41% Island type 13 cases, accounting for 13.26% ; and Island type and tongue type mixed in 18 cases, accounting for 18. 37%. Clinical manifestation：The majority of the patients had no obvious symptoms, while only a small portion had acid re- flux, belching, substernal burning sensation or deglutitiqn discomfort. These patients mainly had a combination of reflux esophagitis and bile reflux gastritis. Treatment：（1）The diet adjustment： avoid eating the food that are too acid, too hot, too hard, and too spicy ; eating less before going to bed ;（2）Drug therapy： Inhibition of gastric acid, resistance of gastric reflux, protection of gastric mucosa and symptomatic treatment ;（3）For a single large or multiple lesions of esophagus island Barrett or the length of BE 〉15mm, treated by APC or repeated treat- ments;（4）Confirmed adenocarcinoma of the esophagus with severe dysplasia needs a surgery. Conclusion：Endo- scopic follow--up examination is of great significance to Barrett＇ s esophagus diagnosis and early esophageal ade- nocarcinoma detection.

关 键 词：BARRETT食管 内镜下表现 治疗 

分 类 号：R573[医药卫生—消化系统]