氩离子凝固术治疗疣状胃炎40例

Argon plasma coagulation in the endoscopic treatment of verrucosal gastritis

目的探讨氩离子凝固(APC)术治疗疣状胃炎的疗效.方法选择上海瑞金医院2000-01/08内镜诊断为成熟型疣状胃炎患者40例,先行内镜检查,同时行幽门螺杆菌(Hp)检测及病理组织学检查,首先给予达克普隆+甲硝唑+丽珠得乐,4 wk 舌复查内镜并使用氩离子凝固术,以1s～3s/次的时间施以氩离子凝固治疗,根据病灶的大小采用不同的次数,以内镜下所有疣状病灶灼除后粘膜平坦或略凹为止.所有病例治疗1mo 后进行临床随访及内镜复查.结果 APC 术治疗40例成熟型疣状胃炎,病灶数共计212枚,平均每枚病灶治疗时间为4.96s(范围2.5s～5s).1mo 后随访,38例(95%)患者临床症状明显改善.内镜复查发现,原病灶处均覆有新生的粘膜上皮及肉芽组织,无明显疤痕形成.2例(5%)患者仍见少许疣状灶及糜烂残留,再次行 APC 术治疗.结论疣状胃炎临床治疗颇为困难,作者经初步研究证实,APC 术操作简便,易于掌握.应用 APC 术为消除成熟型疣状胃炎病灶的一种有效方法.

AIM To investigate the endoscopic treatment of verrucosal gastritis with Argon plasma coagulation (APC). METHODS Fourty patients admitted through Jan.2000 to Aug.2000 for mature verrucosa gastritis to Shanghai Ruijin Hospital were treated with Argon plasma coagulator.After being diagnosed with endoscopy and pathohistology and treated by combined medicine,they were treated with Argon plasma coagulators.The treatment time depended on the size of the lesion.All cases were rechecked by endoscopy after 1 month. RESULTS Fourty(212 lesions)patients with mature verrucosa gastritis were treated by APC,the average duration of treatment was 4.96s(from 2.5s to 5s).After 1 month,38 patients(95%)were improved in clinical symptoms.The endoscopic recheck showed that the lesion area had been covered by normal mucosa and new granulation tissues.A few verrucosa and erosive lesions were still found in 2 patients(5%)who were treated again by APC. CONCLUSION APC is an alternative method in the treatment of verrucosa gastritis with good effects.