窄带放大内镜下氩离子凝固术联合奥美拉唑治疗Barrett食管的临床研究  

Narrow band imaging with high resolution magnification endoscopy directed argon plasma coagulation with taking proton pump inhibitor for Barrett's esophagus

作　　者：王爱民[1,2] 苏军凯[1,2] 刘将[1,2] 唐庆林[1,2] 张帅[1,2] 张鸣青[1,2] 

机构地区：[1]解放军第175医院 [2]厦门大学附属东南医院消化内科,福建省漳州市363000

出　　处：《疑难病杂志》2013年第12期927-929,F0003,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察窄带成像放大内镜(NBI-ME)下氩离子凝固术(APC)联合奥美拉唑治疗Barrett食管(BE)的临床疗效。方法 24例经病理证实伴有上皮内瘤变和/或肠上皮化生的BE患者,在NBI-ME监视下行APC治疗,继之予奥美拉唑20 mg,每天2次,抑酸治疗。末次治疗后行12个月的内镜随访,内镜随访时对再生的鳞状上皮及可疑病灶进行活检。结果 24例患者共接受36次APC治疗,1个月后有22例(91.6%)达到完全的鳞状上皮再生,1例(4.2%)在再生的鳞状上皮间出现柱状上皮岛,1例(4.2%)在可疑病灶中发现上皮内瘤变,1年后总有效率70.8%(17/24),复发和残留7例(29.2%)。结论 NBI-ME下APC联合抑酸治疗BE安全有效,但仍有一定比例的复发和残留。Ohjeetive To observed narrowband imaging magnifying endoscopy （NBI-ME） under argon plasma coagulation （APC） plus omeprazole treatment of Barrett＇s esophagus （BE） clinical efficacy. Methods 24 eases confirmed by pathology associated with intraepithelial neoplasia and / or intestinal metaplasia of BE patients in the NBI ME monitoring downstream APC treatment, followed by omeprazole 20 mg, twice daily, acid suppression therapy. Last treatment underwent endoscopic follow-up of 12 months, endoscopic follow-up on the regeneration of squamous epithelium and suspicious lesions for biopsy. Results 24 patients received a total of 36 times APC treatment, a month later, 22 cases （91.6%） achieved complete squamous epithelial regeneration, 1 ease （4.2%） in the regeneration occurs between squamous columnar epithelium Island, 1 ease （4.2%） was found in suspicious lesions intraepithelial neoplasia, one year after the total efficiency of 70.8% （ 17/24）, and the remaining seven eases of recurrence （29.2%）. Conclusion NBI-ME BE under APC combined acid suppression therapy is safe and effective, but there is still a certain percentage of recurrence and residual.

关 键 词：窄带放大内镜 氩离子凝固术 BARRETT食管 治疗 

分 类 号：R571[医药卫生—消化系统]