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目的探讨Ｎｄ∶ＹＡＧ激光对上消化道粘膜重度不典型增生的治疗作用。方法经胃镜和活检证实为上消化道粘膜重度不典型增生患者３０例，病变位于食管１５例、贲门２例、胃１３例；胃镜下观察病变呈糜烂型１５例、充血型６例、微隆起型５例、浅溃疡型４例。激光治疗时，先在病灶周围注射生理盐水，使病灶局部膨隆，再用Ｎｄ∶ＹＡＧ激光照射，功率３０Ｗ，准接触连续扫描照射病灶至凝固或汽化。激光治疗后１个月复查，胃镜检查见病灶消失、活检无不典型增生为近期痊愈。结果３０例患者中，经１次治疗后近期痊愈２６例，经２次治疗后近期痊愈４例，总近期痊愈率１００％，未发生副作用或并发症。结论Ｎｄ∶ＹＡＧ激光治疗上消化道粘膜重度不典型增生，效果确切，安全简便，痛苦少，费用低，可以门诊治疗，值得深入研究和推广应用。
Objective To investigate the therapeutic effect of Nd:YAG laser on the severe atypical hyperplasia of upper digestive tract mucosa. Methods Thirty patients with severe atypical hyperplasia of upper gastrointestinal mucosa were confirmed by gastroscope and biopsy. The lesions were located in esophagus in 15 cases, cardia in 2 cases and stomach in 13 cases. Gastroscopy showed erosive lesions in 15 cases, hyperemia in 6 cases, 5 cases, 4 cases of shallow ulcer. Laser treatment, the first injection of saline around the lesion, so that the local bulging lesions, and then Nd: YAG laser irradiation, power 30W, quasi-continuous exposure to contact with the lesion to coagulation or vaporization. One month after laser treatment review, gastroscopy see the lesions disappear, no typical biopsy for the recent recovery. Results Of the 30 patients, 26 patients recovered immediately after one treatment and 4 patients recovered soon after 2 treatments. The total recovery rate was 100%. No side effects or complications occurred. Conclusion Nd:YAG laser treatment of severe atypical hyperplasia of the upper gastrointestinal mucosa, the exact effect, safe and easy, less pain, low cost, you can out-patient treatment, it is worth in-depth study and promotion.