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目的:观察无痛胃镜下氩离子凝固术(argon plasma coagulation,APC)治疗颈段食管胃黏膜异位症(heterotopic gastricmucosa in the upper esophagus,HGMUE)的效果。方法:经组织病理证实HGMUE患者68例,均在无痛胃镜下行APC治疗,术后给予奥美拉唑40 mg/次,1次/d口服,至不适症状缓解后改为20 mg/次,1次/d,维持4周。治疗后第3,6,12个月复查胃镜,观察治疗效果及并发症发生情况。结果:68例患者均经1次APC治疗即完全消除异位黏膜,均未发生出血、穿孔、感染、狭窄等严重并发症。3例6个月后复发再行APC治疗后随访6个月未复发;64例随访12个月1例胃镜下见复发病灶,2例失访。APC术后出现轻度咽部不适52例,出现轻度吞咽困难2例,均逐渐缓解。结论:无痛胃镜下APC治疗颈段食管胃黏膜异位症安全、有效。
Objective: To observe the effect of argon plasma coagulation (APC) on cervical heterotopic gastric mucosa in the upper esophagus (HGMUE). METHODS: Sixty-eight HGMUE patients were confirmed by histopathology and were treated with APC under painless endoscopy. Omeprazole was given 40 mg orally and once daily after oral administration until the symptoms were relieved and then changed to 20 mg orally. 1 times / d, for 4 weeks. Gastroscopy was performed at 3, 6, and 12 months after treatment to observe the therapeutic effect and the incidence of complications. Results: All the 68 patients were treated with APC, which completely eliminated the ectopic mucosa. No serious complications such as bleeding, perforation, infection and stenosis occurred. 3 cases were relapsed after 6 months and APC recurrence was followed up for 6 months without recurrence; 64 cases were followed up for 12 months, 1 case of recurrent lesions under endoscopy and 2 cases lost. There were 52 cases of mild pharyngeal discomfort after APC, 2 cases of mild dysphagia, all gradually relieved. Conclusion: APC is safe and effective in the treatment of cervical esophageal and gastric mucosal endometriosis under painless gastroscope.