摘要
目的观察单用药物及内镜下射频消融术(ERFA)联合药物治疗藏区巴雷特食管患者的疗效,为藏区巴雷特食管患者探寻更安全有效的治疗方法。方法选取2017年1月至2018年6月就诊于西藏自治区人民政府驻成都办事处医院消化内科的患者160例,经胃镜及病理检查证实为巴雷特食管。其中,男性84例、女性76例,年龄24~78岁,平均年龄(50.6±12.2)岁。采用数字表法随机分为药物治疗组和ERFA联合治疗组两组,每组80例。药物治疗组采用质子泵抑制剂及粘膜保护剂治疗1个月;ERFA联合治疗组给予ERFA联合质子泵抑制剂及粘膜保护剂治疗。所有受试者均于术前、术后3个月、术后1年分别观察临床症状、胃镜及病理改变,并记录病变类型、大小、ERFA操作时间、术中出血量、术后住院时间、术后近期及远期并发症。结果两组患者在人口学信息、症状、形态分型及长度分型方面无显著性差异(P>0.05)。术前、术后3个月、术后1年复查胃镜及病理活检,胃镜下表现及病理活检有效性显示,药物治疗组均显著高于ERFA联合治疗组,差异有统计学意义(P<0.05)。ERFA操作便捷、快速,术中出血量少,术中、术后仅有不同程度的一过性不良反应,无近期及远期严重并发症。结论对于藏区巴雷特食管患者,采用ERFA联合药物与单用药物治疗,均能有效改善临床症状,但前者在内镜、病理改善方面明显优于后者。本研究说明RFA联合质子泵抑制剂及粘膜保护剂治疗是一种治疗巴雷特食管的便捷、安全、有效的方法。
Objective To observe the efficacy of single drug and endoscopic radiofrequency ablation(ERFA)combined with drug in the treatment of Tibetan barrette esophageal patients,and to explore a safer and more effective treatment for Tibetan barrette esophageal patients.Methods A total of 160 patients admitted to the department of gastroenterology of Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region from January 2017 to June 2018 were selected.Among them,84 males and 76 females were aged from 24 to 78 years,with an average age of(50.6±12.2)years.Two groups were randomly divided into the drug treatment group and the ERFA combined treatment group using the number table method,with 80 cases in each group.The drug treatment group was treated with proton pump inhibitor and mucosal protectant for 1 month.The ERFA combined therapy group was treated with ERFA combined proton pump inhibitor and mucosal protectant.All subjects were observed with clinical symptoms,gastroscope and pathological changes before surgery,3 months after surgery and 1 year after surgery,and the pathological types,sizes,ERFA operation time,intraoperative blood loss,postoperative length of stay,and short-term and long-term postoperative complications were recorded.Results There was no significant difference between the two groups in demographic information,symptoms,morphological classification and length classification(P>0.05).Gastroscope and pathological biopsy were reviewed before,3 months after and 1 year after the operation.The endoscopic performance and the effectiveness of pathological biopsy showed that the drug treatment group was significantly higher than the ERFA combined treatment group,and the difference was statistically significant(P<0.05).The operation of ERFA is convenient and fast,with less intraoperative blood loss,only transient adverse reactions of different degrees during and after the operation,and no short-term and long-term serious complications.Conclusion The combination of ERFA and single drug therapy
作者
潘雯
刘超
任涛
李晓萍
高薇娜
梁翠婷
刘秋梅
Pan Wen;Liu Chao;Ren Tao;Li Xiaoping;Gao Weina;LiangCuiting;Liu Qiumei(Department of Geratology,Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region(Hospital.C.T.),Chengdu,Sichuan 610041,China)
出处
《中华胃食管反流病电子杂志》
2020年第1期46-53,共8页
Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)
基金
西藏自治区人民政府驻成都办事处医院院级科研项目(2017-YJ-2)
四川省卫生和计划生育委员会科研项目(17PJ012)。
