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目的探讨内镜染色指示下射频消融术治疗食管不典型增生的疗效和安全性。方法对内镜检查发现食管有可疑病灶的病人用2%碘溶液食管染色后,在染色指示下多点取活检,经病理诊断为不典型增生,超声内镜检查病变局限于黏膜层者,在染色内镜直视下从病灶周围0.3~0.5cm处开始先射频点灼上下左右4点以标记切除范围,然后自病灶边缘向中心规律地射频消融治疗,功率为35W。每个接触部位治疗时间3~4s,使病灶及周围0.3~0.5cm以内黏膜及黏膜下层碳化为止。结果65例食管不典型增生(轻度18例,中度31例,重度16例)患者经1次染色内镜下射频消融治疗,随访6周~7年,所有病人痊愈,未发生出血、穿孔等并发症。结论射频消融术可作为阻断食管癌变发生发展的首选方法。
Objective To investigate the efficacy and safety of endoscopic radiofrequency ablation for the treatment of esophageal atypical hyperplasia. Methods After esophageal mucosal lesions were found by esophageal endoscopy in esophageal cancer with 2% iodine solution staining, biopsies were taken under the instruction of staining, pathologically diagnosed as atypical hyperplasia, endoscopic ultrasonography was confined to the mucosa, Stained endoscopy under the eyes from 0.3 ~ 0.5cm around the lesion began radiofrequency around 4 points to mark the excision range, and then from the edge of the focus to the center of the RF radiofrequency ablation treatment, the power of 35W. Each contact site treatment time 3 ~ 4s, the lesions and the surrounding 0.3 ~ 0.5cm mucosa and submucosa carbonized up. Results 65 patients with esophageal atypical hyperplasia (18 mild, 31 moderate and 16 severe) underwent endoscopic radiofrequency catheter ablation. The patients were followed up for 6 weeks to 7 years. All patients recovered without hemorrhage and perforation Other complications. Conclusion Radiofrequency ablation can be used as the first choice to block the development of esophageal carcinogenesis.