黏膜切除术及氩离子凝固术治疗胃黏膜脱垂症

目的探讨内镜黏膜切除术（edoscopic mucosal resection，EMR）及氲离子凝固术（argon plasma coagu-1ation，APC）在治疗胃黏膜脱垂症（gastric mucosa prolapse，GMP）中的作用。方法将胃镜确诊113例胃黏膜脱垂症患者随机分为标准EMR组（40例）、氩离子凝固术组（40例）和对照组（33例）；治疗组术后及对照组均采用内科药物治疗4周；1个月后行症状随访及胃镜复查，进行疗效评价。结果标准EMR组、氩离子凝固术组和对照组随访症状缓解总有效率分别为94．87％、90．00％和32．26％，治疗组与对照组相比，差异有统计学意义（P〈0．01）；两治疗组比较差异无统计学意义（P〉0．05）。胃镜复查总有效率分别为97．37％、91．89％和16．7％；治疗纽与对照纽相比，差异有统计学意义（P〈0．01），两治疗组相比差异无统计学意义（P〉0．05），但EMR组（92．10％）的显效比例高于APC组（73．00％）（P〈0．05）。结论标准EMR治疗胃黏膜脱垂是一种安全、有效的微创治疗手段。

Clinical study of gastric mucosa prolapse treated by endoscopic mucosal resection and argon plas-ma coagulation

Objective To investigate the effects of endoscopic mucosal resection （EMR）and ar-gon plasma coagulation（APC） on gastric mucosa prolapse（GMP）. Methods One hundred and thirteen patients with gastric mucosa prolapse diagnosed by gastroscopy were randomly divided into standard EMR group（n =40） ,APC group（n =40） and control group （n = 33 ）. All patients had medical therapy for 4 weeks. These patients were followed up for the changes of symptoms and gastroscopy after 1 month, and the effect was evaluated. Results Compared with control group （32.26%）, the totalsymptom relieve effective rate of standard EMR group （94.87%） and APC group （90.00%） was higher （ P 〈 0.01 ）. But there was no sig-nificant difference in total symptom relieve ef-fective rate between EMR group and APC group （P 〉 0.05 ）. Compared with control group （ 16.7% ）, the total effective rate by gastroscopy reexamination of standard EMR group （97.37 % ） and APC group （91.89%）was higher （P 〈0.01）. But there was no significant difference in total effective rate by gas-troscopy reexamination between EMR group and APC group （ P 〉 0.05 ）. The proportion rate of endo-scopic curative effect in EMR group （92. 11% ） was significantly higher than that in APC group （72.97%） （P 〈 0.01 ）. Conclusions Standard EMR treatment of gastric mucosa prolapse is a safe and effective minimally invasive treatment method.