放大染色胃镜下射频治疗疣状胃炎68例临床观察

Magnifying chromogastroscopic radio frequency in treatment of clinical observation of 68 cases of verrucose gastritis

目的观察放大染色胃镜下射频治疗疣状胃炎的临床效果。方法应用放大内镜结合美兰染色,对疣状隆起改变的胃炎病灶进行胃黏膜细微结构形态学观察,将胃小凹为D、E和F型的68例患者纳入治疗,应用射频对病灶进行治疗,术后常规给予质子泵抑制剂或抗生素等治疗,3个月后复查疗效。结果射频治疗疣状胃炎病灶306处,每个患者平均4.5处,3个月后随访复查,临床症状明显改善63例(92.65%),经放大染色胃镜复查发现,患者病灶基本消除59例(86.76%),胃小凹为A、B型患者49例(72.06%),C型10例(14.71%),仍为D、E和F型,需要再次行射频治疗5例(7.35%)。射频治疗后部分患者出现上腹部隐痛等症状,无出血、穿孔等严重并发症。结论放大染色胃镜能准确识别胃小凹形态,使射频能更准确地治疗疣状胃炎病灶,且疗效显著,操作安全简便。

Objective To observe the clinical efficacy and value of magnifying chromogastroseopic Radio frequency in treatment of verrucose gastritis.Methods Magnifying endoscope in combination with methylene blue staining were used to observe the micro-structures of gastric mucosa in patients with verrucose gastritis.68 cases with gastric pit types D,E and F were treated with Radio frequency.Three month after treatment.the patients were once more observed and evaluated clinical effects.Results Radio frequency had treated 306 foci of verrucose gastritis.with an average of 4.5 foci in each patient.Three-month follow-up showed that 63 cases（92.65%）with ameliorated symptoms,while 59 cases（86.76%）of them were with good results（free symptoms）.49 patients（72.06%） were with gastric pit types A and B,10 cases（14.71%）with gastric pit type C,5 cases（7.35%）of the patients still had symptoms.The patients,who still had gastric pit types D,E and F,needed to be treated by Radio frequency again.Part of patients after receiving treatment of Radio frequency had upper abdominal hidden painand so on.No serious complication of Hemorrhage,perforation and so on occurred.Conclusion Magnifying hromogastroscopy can accurately identify the micro-structures and shapes of gastric pit,which makes it easy,accurate and effective to treat verrucose gastritis.Not only the curative effect is remarkable,moreover safe simple.