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目的:研究氩离子凝固术联合药物治疗对Barrett食管的疗效及安全性。方法:经胃镜及病理组织活检确诊的Barrett食管患者113例,随机分为3组,Ⅰ组23例为对照组,未给予治疗;Ⅱ组33例给予口服奥美拉唑;Ⅲ组48例行氩离子凝固术后并口服药物(同Ⅱ组)维持,3个月后复查,若发现有残留Barrett食管,再次行氩离子凝固术治疗1次。所有患者治疗1年,并在治疗6个月及12个月时复查内镜并行病理组织活检,比较3组治疗前、后临床症状、胃镜检查及病理组织活检结果。结果:Ⅰ组临床症状无明显改变,Ⅱ组与Ⅲ组均较治疗前明显改善。Ⅰ组与Ⅱ组Barrett食管未见明显变化。Ⅲ组能使89.6%的Barrett食管达到胃镜下完全消除,1年后复发率为25.6%,至随访结束时,完全缓解Barrett食管占治疗的66.7%。结论:氩离子凝固术联合药物治疗既可改善Barrett食管的症状,也可消除Barrett食管,但复发率较高。
Objective: To study the efficacy and safety of argon plasma coagulation combined with drug therapy on Barrett’s esophagus. Methods: 113 patients with Barrett ’s esophagus diagnosed by endoscopy and pathological biopsy were randomly divided into 3 groups. 23 cases in group Ⅰ were treated as control group, while 33 cases in group Ⅱ received oral omeprazole. Group Ⅲ was 48 cases Argon ion coagulation and oral medication (with Ⅱ group) to maintain, 3 months after the review, if found residual Barrett’s esophagus, argon ion coagulation again treatment. All the patients were treated for one year. The biopsies of endoscopic parallel pathological tissues were reviewed at 6 months and 12 months after treatment. The clinical symptoms, gastroscopy and pathological biopsy results were compared between the 3 groups before and after treatment. Results: There was no significant change in clinical symptoms in group Ⅰ, while those in group Ⅱ and Ⅲ were significantly improved compared with those before treatment. There was no significant change in Barrett ’s esophagus between group Ⅰ and Ⅱ. In group Ⅲ, 89.6% of Barrett ’s esophagus were completely eliminated under endoscopy. The recurrence rate was 25.6% after 1 year. At the end of follow - up, 66.7% of Barrett’ s esophagus was completely relieved. Conclusion: Argon plasma coagulation combined with medical treatment can improve the symptoms of Barrett’s esophagus and eliminate Barrett’s esophagus, but the relapse rate is higher.