CAJ | 학술논문

目的：探讨内镜下高频电凝加PPI治疗短段Barrett食管（SSBE）疗效及安全性。方法经内镜及病理检查确诊的60例舌型及岛型SSBE患者分为两组，治疗组30例行内镜下高频电凝加口服雷贝拉唑20 mg，2次／日，维持抑酸治疗4周；对照组30例单纯给予口服雷贝拉唑20 mg，2次／日，治疗4周，后减量至20 mg，1次／日，维持治疗1年；分别于治疗后3、6、12、18及24个月复查胃镜并取活组织送病理检查。治疗组中复查胃镜未达显效的患者，再次行内镜下高频电凝治疗并予口服PPI治疗4周。结果治疗组平均显效率为87．0％，总有效率为100％，与对照组（8．1％，27．8％）相比，差异有统计学意义（P＜均0．01）；治疗组未出现出血、穿孔及食管狭窄等并发症。结论内镜下高频电凝加PPI治疗SSBE疗效明显，安全，并发症少。
목적：탐토내경하고빈전응가PPI치료단단Barrett식관（SSBE）료효급안전성。방법경내경급병리검사학진적60례설형급도형SSBE환자분위량조，치료조30례행내경하고빈전응가구복뢰패랍서20 mg，2차／일，유지억산치료4주；대조조30례단순급여구복뢰패랍서20 mg，2차／일，치료4주，후감량지20 mg，1차／일，유지치료1년；분별우치료후3、6、12、18급24개월복사위경병취활조직송병리검사。치료조중복사위경미체현효적환자，재차행내경하고빈전응치료병여구복PPI치료4주。결과치료조평균현효솔위87．0％，총유효솔위100％，여대조조（8．1％，27．8％）상비，차이유통계학의의（P＜균0．01）；치료조미출현출혈、천공급식관협착등병발증。결론내경하고빈전응가PPI치료SSBE료효명현，안전，병발증소。
Objective To study the clinical efficacy of endoscopic high-frequency electrocoagulation combined with proton pump inhibitor (PPI)in the treatment of tongue-and island-type SSBE. Methods Sixty patients pathologically diagnosed with tongue-and island-type SSBE were divided into the treatment (n=30 ) and control groups (n =30 ). In the treatment group,patients were treated with endoscopic high-frequency electrocoagulation combined with 20 mg of rabeprazole twice daily for 4 consecutive weeks,while the counter-parts in the control group were treated with 20 mg of rabeprazole twice daily for 4 consecutive weeks,and the dose was reduced to 20 mg of rabeprazole once daily and the maintenance therapy was delivered for 1 year. All patients underwent gastroscopy and biopsy samples were collected for pathological examination at 3,6,12,18 and 24 months after treatment beginning. The patients in the treatment group achieved no significant efficacy repeatedly received endoscopic high-frequency electrocoagulation and rabeprazole administration for another 4 weeks. Results In the treatment group,average significant efficacious rate was 87. 0% and total efficacious rate was 100%,significantly higher compared with 8. 1% and 27. 8% in the control group (both P<0. 01 ). No postoperative complications,such as bleeding,perforation,esophagostenosis were observed in the treatment group. Conclusions Endoscopic high-frequency electrocoagulation combined with PPI is an efficacious and safe treatment of SSBE,and yields few complications.