CAJ | 학술논문

目的探讨内镜下冷冻消融术治疗Barrett食管(BE)的临床疗效.方法 2008年1月至2009年5月间对22例经胃镜检查确诊为BE的患者进行了内镜下压缩二氧化碳冷冻治疗,对其疗效、疗程和并发症发生情况进行总结和分析.结果 22例患者中除2例中途退出研究外,其余20例通过1～3次冷冻消融治疗均取得BE黏膜组织学完全逆转,其中9例获得内镜完全逆转、11例获得内镜有效逆转.随访6个月,20例患者中仅有3例出现复发,其中2例为隐性肠化生、1例存在轻度肠化上皮,BE黏膜总的组织逆转率为85%(17/20).此20例患者共进行了42次冷冻治疗,平均2.1次/例,其中1例发生食管溃疡,3例发生中、重度食管炎,均予药物对症治疗后愈合.结论内镜下冷冻消融术治疗BE是安全有效的,近期疗效较好,并且操作简便、并发症少、依从性好.
목적 탐토내경하냉동소융술치료Barrett식관(BE)적림상료효.방법 2008년1월지2009년5월간대22례경위경검사학진위BE적환자진행료내경하압축이양화탄냉동치료,대기료효、료정화병발증발생정황진행총결화분석.결과 22례환자중제2례중도퇴출연구외,기여20례통과1～3차냉동소융치료균취득BE점막조직학완전역전,기중9례획득내경완전역전、11례획득내경유효역전.수방6개월,20례환자중부유3례출현복발,기중2례위은성장화생、1례존재경도장화상피,BE점막총적조직역전솔위85%(17/20).차20례환자공진행료42차냉동치료,평균2.1차/례,기중1례발생식관궤양,3례발생중、중도식관염,균여약물대증치료후유합.결론 내경하냉동소융술치료BE시안전유효적,근기료효교호,병차조작간편、병발증소、의종성호.
Objective To evaluate the therapeutic effect of endoscopic cryotherapy for Barrett's esophagus (BE). Methods A total of 22 consecutive patients, who were diagnosed as BE from January 2008 to May 2009, underwent endoscopic cryotherapy by using pressurized gas of C02. The data including effective rate, therapy courses and procedure related complications were retrospectively analyzed.Results Except for 2 cases of withdrawal, the other 20 patients completed the treatment with a total therapy number of 42 times (mean 2. 1 times/patient) and were followed up for 6 months. Complete histologic reversal of BE mucus was achieved in all 20 patients after 1-3 times of cryotherapy, among whom complete endoscopic reversal was obtained in 9 and effective endoscopic reversal in 11. Histologic recurrence was observed in 3 cases during the follow-up, including 2 of occult intestinal metaplasia and 1 of mild intestinal metaplasia, which achieved a BE mucosal reversal rate of 85% (17/20). Procedure related complications included 1 case of esophageal ulcer and 3 cases of mild or severe esophagitis, which were all cured after acid suppression treatment. Conclusion Endoscopic cryotherapy in BE is effective and safe, with the advantages of easy manipulation, less complications and good compliances.