内镜电凝加PPI治疗岛型及舌型SSBE疗效观察

Clinical effect of high-frequency electrocautery combined with PPI treatment for island-type and tongue-type short-segment Barrett′s esophagus

目的观察内镜下高频电凝加PPI治疗岛型及舌型SSBE的近中期疗效及安全性。方法经内镜及病理检查确诊的岛型及舌型SSBE病例39例,随机及自愿结合分组。23例治疗组患者在内镜下对岛型及舌型SSBE病灶施行高频电凝治疗,同时口服雷贝拉唑,20mg,bid,疗程4周。16例对照组患者则单纯予雷贝拉唑口服,20mg,bid,持续抑酸治疗。分别于治疗后第3个月、6个月、12个月、18个月及24个月行胃镜随访,对照原内镜图片,观察各组岛型及舌型SSBE病灶的变化,并在原病灶处取活组织检查其病理改变。对治疗组中复查内镜未达显效者,再次行镜下电凝治疗并予雷贝拉唑口服,20mg,bid,疗程4周。结果治疗组随访病例平均显效率87.6%,总有效率100%;未出现出血、穿孔及食管狭窄等并发症。对照组平均显效率6.6%,平均总有效率26.5%,平均无效率73.5%。结论经内镜下高频电凝加PPI治疗岛型及舌型SSBE安全,近期疗效明显。

Objective To evaluate the efficacy of high-frequency electrocautery combined with PPI treatment on island-type and tongue-type short-segment Barrett′s esophagus. Methods Thirty-nine patients with island-type or tongue-type SSBE diagnosed with endoscopy and biopsy were randomly divided into treatment group and control group. Treatment group were treated with high-frequency electrocautery combined with rabeprazole for 4 weeks. Control group were treated with rabeprazole only. All patients were received the endoscopic review and biopsy at 3, 6, 12, 18 and 24 months. If there was residual Barrett′s esophagus in treatment group, high-frequency electrocautery and rabeprazole was repeated. Results Total effective rate was 100% in treatment group,while the total effective rate was only 26.5% in control group. All patients who received high-frequency electrocautery were no complications, such as bleeding, perforation, esophagostenosis. Conclusion High-frequency electrocautery combined with rabeprazole therapy was efficacy and safe for island-type and tongue-type SSBE.