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目的探讨内镜下射频消融术治疗食管和胃的低级别上皮内瘤变的有效性及安全性。方法回顾性分析解放军总医院消化内镜中心2014年10月至2015年1月行内镜检查,经病理证实为食管或胃低级别上皮内瘤变的21例患者纳入研究,经门诊行内镜下射频消融治疗,其中食管部病变射频消融2次,胃部病变射频消融3次,术后采用Wang-Baker面部表情量表进行疼痛评分,治疗后1个月进行内镜复查。结果 21例共计31个低级别上皮内瘤变病灶纳入研究。16例共计23个低级别上皮内瘤变病灶进行了复查,其中14例患者,21个病灶经射频治疗后消失,病灶消除率91.30%(21/23);2例患者2个低级别上皮内瘤变病灶出现残留,病灶残留率8.70%(2/23)。16例复查患者病灶治疗部位黏膜均愈合,术后腹痛为主要并发症。结论内镜下射频消融术治疗食管和胃低级别上皮内瘤变是安全、有效、并发症小、可门诊治疗的一种新方法。
Objective To investigate the efficacy and safety of endoscopic radiofrequency ablation in the treatment of low-grade intraepithelial neoplasia of esophagus and stomach. Methods A retrospective analysis of PLA General Hospital digestive endoscopy center from October 2014 to January 2015 endoscopic examination, pathologically confirmed 21 cases of esophageal or gastric low-grade intraepithelial neoplasia were included in the study, the endoscopic endoscopic Radiofrequency ablation was performed. The esophageal lesion was radiofrequency ablated twice and the gastric lesion was radiofrequency ablated three times. The postoperative pain score was evaluated by Wang-Baker facial expression scale. One month after treatment, endoscopic examination was performed. Results A total of 31 low-grade intraepithelial neoplasia lesions were included in 21 cases. Totally 23 low-grade intraepithelial neoplasia lesions were retrospectively examined in 16 cases. Among 14 cases, 21 lesions disappeared after radiofrequency ablation and the lesions were eliminated by 91.30% (21/23). In 2 cases, 2 low-grade intraepithelial neoplasia Necrosis lesions remain, the residual rate of 8.70% (2/23). 16 cases of re-examination in patients with mucosal lesion healing, postoperative abdominal pain as the main complication. Conclusions Endoscopic radiofrequency ablation for the treatment of esophageal and gastric low-grade intraepithelial neoplasia is a new method that is safe, effective and has low complication.