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目的研究内镜下多环黏膜切除术治疗食管上皮内瘤变的安全性及实用性。方法应用内镜下多环黏膜切除法治疗36例食管上皮内瘤变患者。术后第1、3、6、12月分别复查胃镜。结果 36例中单灶者31例,多灶者5例,共42处病灶,均一次顺利完成病灶切除,术中少量渗血者8例,内镜下处理后均出血停止,术中、术后无发生创面大出血、穿孔等并发症者。术前病检提示低级别上皮内瘤变22例,高级别上皮内瘤变14例;术后病检提示低级别上皮内瘤变20例,高级别上皮内瘤变13例,癌变3例。结论内镜下多环黏膜切除法简单易行,是治疗食管上皮内瘤变,尤其是针对多灶患者及病变面积较大者的安全有效方法。
Objective To study the safety and practicability of endoscopic mucosal resection for esophageal intraepithelial neoplasia. Methods 36 patients with esophageal intraepithelial neoplasia were treated with endoscopic mucosal excision. After the first 1, 3, 6, December were reviewed gastroscopy. Results In 36 cases, there were 31 patients with single lesions, 5 patients with multiple lesions and 42 lesions. All the lesions were resected smoothly in one time. There were 8 patients who received a small amount of bleeding during operation. All patients underwent endoscopic surgery, After the occurrence of wound bleeding, perforation and other complications. Preoperative pathological examination showed 22 cases of low grade intraepithelial neoplasia and 14 cases of high grade intraepithelial neoplasia. The postoperative pathological examination showed 20 cases of low grade intraepithelial neoplasia, 13 cases of high grade intraepithelial neoplasia and 3 cases of canceration. Conclusion Endoscopic polyp mucosal resection is simple and easy, and it is a safe and effective method for the treatment of esophageal intraepithelial neoplasia, especially for patients with multifocal lesions and large lesions.