经内镜氩离子凝固术联合抗幽门螺杆菌治疗隆起糜烂性胃炎探究.docVIP

经内镜氩离子凝固术联合抗幽门螺杆菌治疗隆起糜烂性胃炎探究 　【摘要】 目的 研究应用氩离子凝固术（argon plasma coagulation,APC）联合抗幽门螺杆菌治疗隆起糜烂性胃炎的价值及安全性。方法 将98例隆起糜烂性胃炎患者随机分成A组（先药物后APC治疗组）和B组（药物+APC同时治疗组），比较两种方法的疗效。结果 98例患者83例幽门螺杆菌阳性，35.7%（35/98）的患者发现肠上皮化生。在A组，单纯药物治疗仅有12.5%（6/48）的患者隆起糜烂性病变消失，而应用APC治疗后，90.5%（38/42）的患者隆起糜烂病变消失；在B组，隆起糜烂病变治愈率达92.0%（46/50），与单纯药物治疗比较差异有显著统计学意义（P＜0.01）。APC治疗后仅2例出现黏膜下气肿，且在2周后自动吸收。11例出现轻微上腹胀或上腹隐痛，但均在术后2～3天消失。92例患者共进行了103次APC治疗，共治疗隆起糜烂性病变468个，平均每次治疗用时为12 min。结论 隆起糜烂性胃炎的发病与Hp感染有关，容易发生肠上皮化生。单纯药物治疗疗效欠佳。经内镜氩离子凝固术联合抗幽门螺杆菌治疗隆起糜烂性胃炎不仅疗效显著，而且安全简便。 【关键词】 内镜 氩离子凝固术 幽门螺杆菌 隆起糜烂性胃炎 Study on protuberant erosive gastritis with endoscopic argon plasma coagulation（APC）and anti-helicobacter pylori ［Abstract］ Objective To study the efficacy and safety of the APC and anti-helicobacter pylori applied in patients with protuberant erosive gastritis.Methods 98 patients suffering from protuberant erosive gastritis were divided in to two groups.Group A:treated only with drugs firstly,then by APC;Group B:treated by APC and drugs simultaneously and the efficacy and safety were compared.Results Helicobacter pylori（Hp）positive rate was 84.7%（83/98）,intestinal metaplasia was found in 35.7%（35/98）patients.In group A:treated only with drugs,12.5%（6/48）patients were verified that the protruding lesions disappeared,but after treated with APC,（38/42）90.5% protruding lesions vanished;in group B:cure rate of the protruding lesions was 92.0%（46/50）,significantly higher than the patients only treated with drugs（P＜0.01）.Only 2 cases patients with subcutaneous emphysema disappeared without any treatment after 2 weeks.11 cases patients had abdominal pain or distention which started within 1～2 d after operation and disappeared within 2～3 d.103 times of APC were done and 468 protruding lesions were treated by APC in 92 patients,the average operation time was 12 min.Conclusion Hp infection play a role in the pathogenesis of protuberant erosive gastritis,intestinal metaplasia was found frequently in protruding lesion.Protuberant erosiv