内镜下氩离子凝固术治疗疣状胃炎的临床研究

Clinical study of endoscopic argon plasma coagulation(APC) in the treatment of verrucous gastritis

目的探讨内镜下氩离子凝固术(APC)联合抑酸治疗对疣状胃炎的临床疗效。方法将264例成熟型疣状胃炎患者随机分成两组。治疗组146例在内镜下给予APC联合抑酸及抗HP治疗,对照组118例给予抑酸及抗HP治疗。两组均以6周为治疗终点,复查胃镜及HP,对比两组临床症状缓解积分及胃内情况变化及HP清除率。结果治疗组胃内疣状隆起清除率为93.8%(137/149),对照组为31.3%(37/118),两组比较,差异有统计学意义(P<0.05)。治疗前,两组上腹痛、烧心、反酸症状积分比较,差异无统计学意义(P>0.05);治疗后,两组患者上述症状积分均明显下降,与治疗前比较,差异有统计学意义(P<0.05);治疗组症状积分均明显低于对照组,两组比较,差异有统计学意义(P<0.05)。结论内镜下氩离子凝固术治疗疣状胃炎安全有效,但氩离子凝固术并不能提高幽门螺杆菌的清除率。

Objective To evaluate the clinical efficacy of endoscopic argon plasma coagulation（ APC）combined with acid suppression therapy in the treatment of verrucous gastritis. Methods A total of 264 cases with mature type verrucous gastritis were divided into treatment group and control group. Patients in treatment group were treated with APC combined with anti-acid and anti-HP treatment,then patients in control group were treated with anti-acid and anti-HP therapy. Both the two groups were treated for 6 weeks as the end point,and the gastroscopy and HP were reviewed,the clinical symptoms of two groups were relieved by the integral and the changes of the stomach and the rate of HP clearance were compared and analyzed.Result The clearance rate of excipuliform apophysis in the treatment group was higher than that in the control group,the difference was statistically significant（ P〈0. 05）. Before treatment,the symptom scores of abdominal pain,heartburn,acid reflux of two groups were not statistically significant（ P〉0. 05）; After treatment,the above symptom scores of the two groups were significantly decreased,compared with before treatment,the difference was statistically significant（ P〈0. 05）; The symptom scores of the treatment group were significantly lower than those of the control group,the difference was statistically significant（ P〈0. 05）.Conclusion Endoscopic argon plasma coagulation（ APC） was safe and effective in treatment of verrucous gastritis,But argon plasma coagulation can not increase the clearance rate of Helicobacter pylori.