氩离子凝固术联合药物治疗Barrett食管疗效分析.doc

氩离子凝固术联合药物治疗Barrett食管疗效分析 王树俊1 曹新广2 方立峰1 王晓霞1 张普选1 张雅菲1 王东芳1 摘要 目的 APC联合埃索美拉唑治疗BE的临床疗效及安全性。方法 将92例BE随机分为A、B治疗组和对照组，A组服用埃索美拉唑及莫沙必利；B组行APC加服与A 组相同的药物；而对照组未予特殊治疗。比较三组患者治疗后的临床症状、内镜表现及组织学改变情况。结果 A、B 治疗组临床症状均明显改善，与对照组相比差异有统计学意义(P0.05)；A 组与对照组内镜表现和组织学改变无明显改善( P0.05)；B组31例（100%）患者BE 食管黏膜内镜表现和组织学恢复正常，与另外两组相比改善有统计学差异( P0.05。结论 APC联合埃索美拉唑、莫沙必利方案可明显改善BE患者的临床症状和内镜表现，是一种安全、有效治疗BE的综合治疗方法。 【关键词】 Barrett食管；氩离子凝固术；组织学；复发 The clinical effect of argon plasma coagulation combined with drugs for the treatment of Barrett’s esophagus Wang Shu-jun* , Cao Xin-guang , Fang Li-feng , Wang Xiao-xia , Zhang Pu-xuan, Zhang Ya-fei, Wang Dong-fang （he First People’S Hospital of Zhengzhou, Zhengzhou，450004, China）Abstract] Objective To investigate the effect and safety of argon plasma coagulation combined with drugs on Barrett’s esophagus( BE ).Methods A total of 93 cases with BE diagnosed by endoscopy and biopsy were randomly divided into three groups. Group A was treated with Esomeprazole and Mosapride. Group B was treated with argon plasma coagulation (APC) and the same drugs used in group A while control group was not special therapy. Three groups were compared on clinical symptoms, endoscopic and histological changes after treatment. Results Clinical symptoms in group A, B significantly improved, while clinical symptoms in control group had no significant improvement (P0. 05) . Group A and control group had no significant improvement on endoscopic and histological changes (P 0. 05) , 100% of BE patients were returned to normal in group B. Endoscopic and histological changes in group B were significantly improved compared with other two groups (P0. 05). Conclusion APC combined with Esomeprazole and Mosapride program can significantly relieve the clinical symptoms and repair mucosa. It is a safe and effective integrated approach to treat BE. Key words: Barrett’s esophagus; Argon plasma coagulation; Histology; Recur rence Barrett食管( Barrett’ s esophagus, BE )是指食管下段的复层鳞状上皮被柱状上皮所取代，伴或不伴肠化的一种病理现象[1