上消化道病内镜微波组织凝固疗法的临床应用与评价

The Clinical Application and Evalution of the Endoscopic Microwave Coagulation of Upper Gastrointestinal Diseases

本文报告应用内镜微波组织凝固疗法(EMCT)治疗胃息肉、胃癌、消化性溃疡三种疾病21例、39次治疗。提出了溃疡面搔刮加微波凝固治疗难治性溃疡、及 EMCT 联合内镜下局部注射化疗治疗进展期胃癌等方法。胃息肉13例27枚及Ⅱa 型早期胃癌1例与消化性溃疡3例全部达到治愈。85.2%的胃息肉 EMCT 一次治疗成功,Ⅱa 型早癌一次成功,消化性溃疡2例一次成功。进展期胃癌4例均达到肿块缩小、狭窄的胃腔扩大与自觉症状改善的效果。鉴于疗效显著,认为三种疾病均适用本疗法;并就 EMCT 的适应症、使用限度和治疗目的作了讨论;展望了以 EMCT 作为早期胃癌经内镜根治疗法手段之一的远景。

From September 1988 to August 1989,21 cases of upper gastrointestinaldiseases were treated by the endoscopic microwave coagulation therapy(EMCT).All of the 21 cases were diagnosed by endoscopy and gastricmucosa biopsy,including 13 cases of gastric polypus (27 polypi),5cases of gastric cancer and 3 cases of persistent peptic ulcer.Gastricpolypus were treated by EMCT only,with first success rate of 85.2%.In treatment of persistent ulcer,we suggested to apply EMCT combinedwith ulcer cleaning by a forceps under endoscopy,2 of the 3 casesrecovered after once such a therapy.One case of the early gasric cancer(Ⅱa)was resolved by EMCT only.Other 4 advanced cases of gastriccancer was treated by EMCT combined with local injection of 5-Fu andmitomycin C around the lesion.All of them got effect for severalmonths temporarily.