氩离子凝固术联合质子泵抑制剂治疗Barrett食管的长期疗效分析

Long-term effect of argon plasma coagulation combined with proton pump inhibitor on Barrett esophagus

目的评估氩离子凝固术（APC）联合质子泵抑制剂（PPI）逆转Barrett食管（BE）的长期疗效。方法对2004年至2007年经胃镜检查并经病理证实的36例BE患者采用APC联合PPI（每天20mg）治疗，分别于治疗后第1、6、12个月复查，以后每年1次内镜随访。结果36例患者共行48次APC治疗，平均1．33次／例，经治疗后均获得BE完全逆转。随访14～51个月，中位时间36个月，BE总复发率为16．7％（6／36），1年复发率为2．8％（1／36），2年复发率为11．1％（4／36）。Logistic回归分析显示，2年复发率和总复发率与APC治疗次数呈明显正相关（P值分别为0．004和0．007）。结论APC联合PPI治疗BE是一种安全、有效的方法，且长期疗效较好。

Objective To study the long-term effect of argon plasma coagulation （APC） combined with proton pump inhibitor （PPI） on Barrett esophagus （BE）. Methods A total of 36 patients, histologically proven as having BE from 2004 to 2007, were enrolled to underwent a therapy of APC plus PPI. The patients were re-examined on endoscopy at l, 6 and 12 months after first APC and once a year thereafter. Results A total of 48 APC sessions were given to 36 patients with a mean number at 1.33 per patient. The effective rate of reversal of BE was 100%. The follow-up was accomplished for all patients in 14-51 months with a median of 36months. The total recurrence rate （RR） of BE reached 16.7% （6/36）. The 1-year and 2-year RRs were 2. 8% （1/36） and 11. 1% （4/36） , respectively. The logistic regression analysis sugges- ted that 2-year and total RRs were related to APC sessions （ P 〈 0. 01 ）. Conclusion The therapy of APC combined with PPI for BE is safe and of long-term effects.