氩离子凝固术联合质子泵抑制剂治疗 Barrett 食管32例疗效观察

目的:研究氩离子凝固术联合质子泵抑制剂治疗Barrett食管的疗效。方法:32例Barrett食管患者行氩离子凝固术,功率为60W,术后给予质子泵抑制剂治疗,在治疗后2~6个月复查胃镜,若病理提示仍有柱状上皮存在,再次进行氩离子凝固术治疗,直至Barrett食管黏膜完全消除。结果:胃镜下27例(84.4%)病灶消失,4例(12.5%)原病灶处可见岛状Barrett食管样改变,再次行氩离子凝固术,1例(3.1%)发现重度异型增生而行手术治疗。18例出现不同程度的胸骨后疼痛症状(56.3%),1例出现吞咽痛(0.3%),未见穿孔、狭窄等并发症发生。结论:氩离子凝固术联合质子泵抑制剂治疗Barrett食管是一种安全有效的方法。

Effects of argon plasma coagulation combined with proton pump inhibitor on Barrett's esophagus in 32 cases

Objective To study the effects of argon plasma coagulation combined with proton pump inhibitor on Barrett's esophagus.Methods Thirty-two patients with Barrett's esophagus diagnosed by endoscope and pathology method were treated with argon plasma coagulation and proton pump inhibitor.Argon plasma coagulation was performed at a power setting of 60 W.All the patients were rechecked by endoscope and pathology methods after 2 to 6 months.The patients were treated with argon plasma coagulation again until the eradication of Barrett's esophagus and the squamous epithelium restoration were assessed.Results Complete eradication was achieved in 84.4% of 27 patients.Four patients(12.5%) had partial reversal who were treated by argon plasma coagulation again.High-grade dysplasia was detected in 1(3.1%) who received surgical operation.Minor complications were observed in 19 patients,18 cases of retrosternal pain(56.3%) and 1 odynophagia(0.3%).There were no major complications such as hemorrhage,esophageal stricture and perforation.Conclusion Argon plasma coagulation combined with proton pump inhibitor has an obvious reversal effect on Barrett's esophagus.