内镜下高频电凝加PPI治疗短段Barrett食管的临床研究  

Clinical efficacy of endoscopic high-frequency electrocoagulation combined with PPI in treatment of short-segment Barrett's esophagus

作　　者：何远琴[1] 侯俊[1] 李静娴[1] 赖敏莉 

机构地区：[1]广东佛山市第二人民医院消化内科,佛山528000

出　　处：《新医学》2014年第12期808-811,共4页Journal of New Medicine

基　　金：广东省佛山市卫生局医学科研计划资助(2012093)

摘　　要：目的探讨内镜下高频电凝加PPI治疗短段Barrett食管(SSBE)疗效及安全性。方法经内镜及病理检查确诊的60例舌型及岛型SSBE患者分为两组,治疗组30例行内镜下高频电凝加口服雷贝拉唑20 mg,2次/日,维持抑酸治疗4周;对照组30例单纯给予口服雷贝拉唑20 mg,2次/日,治疗4周,后减量至20 mg,1次/日,维持治疗1年;分别于治疗后3、6、12、18及24个月复查胃镜并取活组织送病理检查。治疗组中复查胃镜未达显效的患者,再次行内镜下高频电凝治疗并予口服PPI治疗4周。结果治疗组平均显效率为87.0%,总有效率为100%,与对照组(8.1%,27.8%)相比,差异有统计学意义(P<均0.01);治疗组未出现出血、穿孔及食管狭窄等并发症。结论内镜下高频电凝加PPI治疗SSBE疗效明显,安全,并发症少。Objective To study the clinical efficacy of endoscopic high-frequency electrocoagulation combined with proton pump inhibitor （PPI）in the treatment of tongue-and island-type SSBE. Methods Sixty patients pathologically diagnosed with tongue-and island-type SSBE were divided into the treatment （n=30 ） and control groups （n =30 ）. In the treatment group,patients were treated with endoscopic high-frequency electrocoagulation combined with 20 mg of rabeprazole twice daily for 4 consecutive weeks,while the counter-parts in the control group were treated with 20 mg of rabeprazole twice daily for 4 consecutive weeks,and the dose was reduced to 20 mg of rabeprazole once daily and the maintenance therapy was delivered for 1 year. All patients underwent gastroscopy and biopsy samples were collected for pathological examination at 3,6,12,18 and 24 months after treatment beginning. The patients in the treatment group achieved no significant efficacy repeatedly received endoscopic high-frequency electrocoagulation and rabeprazole administration for another 4 weeks. Results In the treatment group,average significant efficacious rate was 87. 0% and total efficacious rate was 100%,significantly higher compared with 8. 1% and 27. 8% in the control group （both P〈0. 01 ）. No postoperative complications,such as bleeding,perforation,esophagostenosis were observed in the treatment group. Conclusions Endoscopic high-frequency electrocoagulation combined with PPI is an efficacious and safe treatment of SSBE,and yields few complications.

关 键 词：Barrett食管 短段 高频电凝术 质子泵抑制剂 临床疗效 

分 类 号：R571[医药卫生—消化系统]