论文部分内容阅读
目的:探讨内镜下氩离子凝固术(APC)联合乌梅汤加减治疗Barrett食管(BE)的临床疗效。方法:经内镜检查及病理组织学检查诊断的BE患者38例,随机分为治疗组18例和对照组20例,两组患者均在内镜下行APC治疗,对照组于术后给予抗反流和抑酸治疗;治疗组于术后给予乌梅汤加减治疗。结果:两组患者治疗后临床症状均明显改善,但组间比较无统计学差异(P>0.05);内镜下疗效比较,治疗后治疗组18例患者中1例半年后失访,其余17例患者半年及1年后镜下随访未见复发;对照组20例患者半年后随访时16例镜下未见复发,2例在原来部位有散在BE上皮残留,2例在其他部位有新BE上皮生长,再次予APC治疗,之后6个月内2次胃镜随访未发现复发。其余16例患者1年后随访有4例在其他部位有新BE上皮生长,对照组1年后复发率为20%,两组患者1年后复发率比较差异有显著性(P<0.05)。结论:APC是经内镜非接触性治疗BE的新方法,短期疗效较好,配合乌梅汤加减可有效地预防BE的复发,提高综合治疗的远期疗效。
Objective: To investigate the clinical efficacy of endoscopic argon plasma coagulation (APC) combined with WuMeiTang decoction for the treatment of Barrett’s esophagus (BE). Methods: 38 cases of BE patients diagnosed by endoscopy and histopathological examination were randomly divided into treatment group (n = 18) and control group (n = 20). Both groups underwent endoscopic APC, while those in control group were given anti- Flow and acid suppression treatment; treatment group after the treatment of Wumei Tang plus treatment. Results: The clinical symptoms of both groups were significantly improved after treatment, but there was no significant difference between the two groups (P> 0.05). Compared with the endoscopic treatment, 1 out of 18 patients in the treatment group were lost after half a year and the remaining 17 No recurrence was found after 6 months and 1 year of follow-up in the patients. In the control group, there were no recurrences in 16 cases at follow-up six months after operation. Two cases had residual BE epithelial cells in the original site and two cases had BE Epithelial growth was again treated with APC and no recurrence was found after 2 endoscopy follow-ups within 6 months. The remaining 16 patients were followed up for 1 year and 4 cases had new BE epithelial growth in other sites. The control group had a recurrence rate of 20% after 1 year. There was significant difference (P <0.05) between the two groups in the recurrence rate after 1 year. Conclusion: APC is a new method of endoscopic non-contact treatment of BE. The short-term curative effect is better. Combined with the addition of UME decoction can effectively prevent the recurrence of BE and improve the long-term curative effect of the combination therapy.