COX-2抑制剂联合高频电凝电切治疗Peutz-Jeghers综合征胃息肉的临床研究

COX-2 inhibitor combined with high frequency electrocoagulation and electrocision in treatment of gastral polyps of Peutz-Jeghers syndrome

目的观察塞来昔布结合胃镜下息肉切除术治疗Peutz-Jeghers综合征胃息肉的效果。方法将42例Peutz-Jeghers综合征胃息肉患者随机分为塞来昔布联合胃镜治疗组和胃镜治疗组，每组2l例。塞来昔布联合胃镜治疗组于胃镜下高频电凝、电切治疗后口服塞来昔布800mg／d，疗程为12个月；胃镜治疗组行胃镜下高频电凝、电切息肉切除术，疗程为12个月。两组均每4个月复查胃镜1次，观察息肉的数目、病理类型。结果塞来昔布联合胃镜治疗组于治疗后4、8、12个月胃息肉消退率分别为94．5％、91．8％和89．8％，而胃镜治疗组分别为83．0％、63．7％和49．3％，两组比较差异有统计学意义（P〈0．01）。息肉的异型增生较单纯的电凝电切治疗后明显减少，差异有统计学意义（P〈0．05）。结论塞来昔布联合胃镜下高频电凝电切治疗Peutz-Jeghers综合征胃息肉效果肯定，且优于单纯胃镜下息肉切除的治疗方法。

Objective To observe the therapeutic effect of celecoxib combined with electric cutting under gastroscopy for gastral polyps of Peutz-Jeghers syndrome. Methods 42 patients diagnosed with Peutz- Jeghers syndrome were randomly divided into 2 groups （n=21）. The celecoxib ＋ gastroscopy group were administered celecoxib 800 mg daily after gastroscopic treatment, while the gastroscopy group were administered high frequency electrocoagulation and electrocision under gastroscopy only. The treatment duration lasted for 12 months. In both groups, the number and pathologic type of polyps were observed through gastroscopy per 4 months. Results The elimination rates 4, 8, and 12 months after the treatment were 94.5%, 91.8%, and 89.8% in the celecoxib ＋ gastroscopy group and were 83.0%,63.7%, and 49.3% in the gastroscopy group, with statistical differences （P〈0.01）. Compared with gastroscopy treatment, combined treatment decreased polypous dysplasia more obviously, with a statistical difference （P〈0.05）. Conclusions Celecoxib combined with high frequency electrocoagulation and electrocision under gastroscopy for gastral polyps of Peutz-Jeghers syndrome is effective and better than single gastral polyps resection under gastroscopy.