微波凝固加抑酸逆转Barrett食管上皮临床研究

Clinical study on reversal of Barrett’ s esophagus with acid suppression and microwave.

目的观察微波凝固加抑酸治疗对 Barrett食管上皮的逆转作用。方法对 31例经内镜和病理确诊的 Barrett食管病人，分别采取微波凝固加质子泵抑制剂（治疗组）和质子泵抑制剂加抗反流（对照组）治疗。于治疗第 3、 6、 12个月进行内镜和病理复查，观察两组 Barrett食管上皮逆转情况。结果治疗组 11例 Barrett食管上皮逆转总有效率 3、 6、 12个月时分别为 63.6％、 70％和 77.8％，而对照组则分别为 0、 0、 25％。治疗组除出现短暂胸骨后疼痛、吞咽疼痛外，无出血、穿孔等并发症。结论长疗程抑酸加抗反流对 Barrett食管上皮逆转有一定作用；微波凝固加抑酸对逆转 Barrett食管上皮疗效高、见效快。

Objective TO study the effect of microwave and acid suppression on revesal of Barrett's esophagus. Methods Out of 31 patients with Barrett' s esophagus ,eleven were treated with microwave and PPI and the rest were treated with PPI and metoclopramide.The results were observed by endoscopy and pathology after 3, 6, 12 months treatment . Results With microwave and PPI the total effective rates of reversal of Barrett's esophagus were 63.6％ ,70％ and 77.8％ ,respectively after 3, 6, 12 months treatment.While with PPI and metoclopramide the total effective rate 25％ was observed after 12 months treatment.There were transient odynophagia and chest pain in patients with microwave therapy,nobleeding and perforation happend.Conclusions The re－ injury of metaplastic epithelium with microwave combining with acidsuppression is effective in the reveral of Barrett’ s esophagus.