氩离子凝固术联合埃索美拉唑治疗Barrett食管的临床研究

Clincical Study of Endoscopic Argon Plasma Coagulation Combined with Esomeprazole for Treatment of Barrett′s esophagus

目的探讨内镜下氩离子凝固术(APC)联合埃索美拉唑治疗Barrett食管(BE)临床疗效。方法选择我院2011年1月至2012年2月经胃镜检查及病理组织学检查诊断的BE患者72例,在内镜下行氩离子凝固术,术后给予埃索美拉唑20mg,2次/d,8周后改为20mg,1次/d,维持治疗24周。于术后第3、6个月进行内镜随访及病理组织学检查,对其疗效、并发症进行评估。结果 72例患者行79次APC治疗,平均烧灼次数1.1次/例,经APC治疗均完全消除BE上皮。其中1次治疗者65例(90.3%),2次治疗者7例(9.7%)。72例患者中65例进行了临床随访,60例完成2次随访,5例完成1次随访。11例治疗期间有轻度并发症,其中9例为胸骨后不适,2例治疗后出现轻度吞咽困难,经抑酸剂和黏膜保护剂治疗1周内症状改善。结论 APC联合埃索美拉唑治疗BE是一种安全有效、操作简便的方法。

Objective To explore the clinical effect of endoscopic plasma coagulation combined with es- omeprazole for treatment of Barrett＇s esophagus. Methods 72 patients with histologically proven BE, selected from Hanyang Hospital from January 2011 to February 2012, were treated with APC and esomeprazole in 24 weeks. All patients were rechecked endoscope and pathology methods at 3 and 6 months. The effect and compli- cations were evaluated. Results Treatments were accomplished in all patients. A total of 79 APC sessions were given to 72 patients with a mean number at 1.1 per patient. The effective rate of reversal of BE was 100%. The eradieaition was obtained in the 65 cases of 72 by only one session （90.3 % ）, 7 cases required two sessions. Sixty-five cases were accomplished following-up. Minor complications such as retrosterual pain and odynophagia occurred in 11 patients were alleviated by acid inhibitors and gastric mucosal protective adrugs in one week. Conclusion The therapy of APC combined with esomeprazole for BE is a rather effective and safe method.