氩离子凝固术在Barrett食管中治疗效果及安全性分析

目的探讨氩离子凝固术（APC）在Barrett食管中治疗效果和安全性。 方法选取2016年1月至2017年2月新疆维吾尔自治区人民医院诊治Barrett食管患者83例临床资料行回顾性分析，根据患者治疗方案分为干预组（APC＋埃索拉唑、莫沙必利治疗，52例）和常规组（埃索拉唑、莫沙必利治疗，31例），比较2组患者症状改善情况、疗效及不良反应发生率。 结果干预组和常规组治疗前反酸、胸骨后疼痛、腹胀评分比较：（5.5±1.1）分vs （5.4±1.3）分，（5.1±1.2）分vs （5.0±1.1）分，（4.9±1.3）分vs （4.7±1.5）分，t=0.3606、0.3635、0.6165，P=0.7194、0.7172、0.5394。干预组和常规组治疗3月反酸、胸骨后疼痛、腹胀评分比较：（2.2±0.3）分vs （2.3±0.5）分，（2.0±0.4）分vs （2.2±0.5）分，（2.1± 0.6）分vs （2.0±0.4）分，t=1.1056、1.9339、0.7881，P=0.2724、0.0569、0.4331。治疗后3月，干预组反酸、胸骨后疼痛、腹胀评分与治疗前比较：（2.2±0.3）分vs （5.5±1.1）分，（2.0±0.4）分vs （5.1± 1.2）分，（2.1±0.6）分vs （4.9±1.3）分；t=20.4657、17.3295、13.8282，P=0.0000。治疗后3月，常规组反酸、胸骨后疼痛、腹胀评分与治疗前比较：（2.3±0.5）分vs （5.4±1.3）分，（2.2±0.5）分vs （5.0± 1.1）分，（2.0±0.4）分vs （4.7±1.5）分；t=11.7771、12.2620、9.2031，P=0.0000。干预组患者治疗总有效率显著于常规组［95.83% vs 70.37%，χ²=7.6172，P=0.0058］。干预组患者和常规组患者不良反应总发生率比较无统计学意义［12.50% vs 14.81% ，χ²=0.0050，P=0.9436］。 结论APC治疗Barrett食管可改善患者病变，具有显著疗效和较高治疗安全性。

Analysis of therapeutic effect and safety of argon plasma coagulation in barrett's esophagus

ObjectiveTo investigate the effect and safety of argon plasma coagulation (APC) in Barrett's esophagus. MethodSelect 83 case of Barrett esophagus patients in our hospital during Jan., 2016~Feb., 2017 as retrospective analysis, patients were divided into intervention group (APC plus exoporazole, mosapride treatment, 52 cases) and routine group (esoprazole, mosapride treatment, 31 cases) according to the treatment plan of patients. The improvement of symptoms was compared between the two groups., efficacy and incidence of adverse reactions. ResultComparison of anti-acid, post-sternal pain and abdominal distension scores in the intervention group and the conventional group before treatment: (5.5±1.1) scores vs (5.4±1.3) scores, (5.1±1.2) scores vs (5.0±1.1) scores, (4.9±1.3) scores vs (4.7±1.5) scores, t is 0.3606, 0.3635, 0.6165, and P is 0.7194, 0.7172, 0.5394. Comparison of anti-acid, post-sternal pain and abdominal distension scores in intervention group and routine group for 3 months: (2.2±0.3) scores vs (2.3± 0.5) scores, (2.0 ± 0.4) scores vs (2.2 ± 0.5) scores, (2.1 ± 0.6)scores vs (2.0 ± 0.4) scores, t is 1.1056、1.9339、0.7881, and P is 0.2724、0.0569、0.4331. After 3 months of treatment, the anti-acid, post-sternal pain, and abdominal distension scores of the intervention group were compared with those before treatment: (2.3±0.5) scores vs (5.4±1.3) scores, (2.2±0.5) scores vs (5.0±1.1) scores, (2.0±0.4) scores vs (4.7±1.5) scores, t is 11.7771、12.2620、9.2031, and P value is 0.0000. After 3 months of treatment, the conventional group was compared with acid, post-sternal pain, and abdominal distension scores before treatment: (2.3± 0.5) scores vs (5.4 ± 1.3) scores, (2.2 ± 0.5) scores vs (5.0 ± 1.1) scores, (2.0 ± 0.4) scores vs (4.7 ± 1.5) scores, t is 11.7771、12.2620、9.2031, and P value is 0.0000. The total effective rate of treatment in the intervention group was significantly higher than that in the conventional group 95.83% vs 70.37%, χ²= 7.6172, P=0.0058]. The overall incidence of adverse reactions in the intervention group and the conventional group was not statistically significant 12.50% vs 14.81%, χ²=0.0050, P=0.9436]. ConclusionAPC treatment of Barrett's esophagus can improve the patient's symptoms and improve the patient's pathology, with a significant effect and higher treatment safety.