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[目的]探讨氩离子凝固术(APC)的输出功率对治疗Barrett’s食管致食管狭窄的影响。[方法]经胃镜检查、病理证实的Barrett’s食管(全周型)患者44例,随机分成A组(22例)、B组(22例)。在氩气流量(2L/min)和作用时间(3s)固定的情况下,A组、B组分别以60 W输出功率、70 W输出功率,在内镜下行氩离子一次性全周喷凝,术后给以质子泵抑制剂辅助治疗,于治疗后4周复查胃镜及超声内镜,观察2组食管修复情况及管壁厚度及管腔有无狭窄。[结果]患者均完成治疗,4周后复查胃镜,A组表现黏膜光滑,部分可见少许白色瘢痕,蠕动正常,未见明显的管腔狭窄;B组表现黏膜色泽灰白色,APC治疗部位有大量瘢痕组织,部分黏膜充血、糜烂,食管管腔明显狭窄;A组:第4周与处理前管壁最大厚度相比较无明显变化(P>0.05);B组:第4周管壁较处理前明显增厚(P<0.05),有统计学意义。[结论]当氩气流量为2L/min、持续时间为3s时功率控制在≤60 W可以避免并发食管瘢痕狭窄。
[Objective] To investigate the effect of argon plasma coagulation (APC) on the esophageal stenosis induced by Barrett’s esophagus. [Method] Forty - four patients with Barrett ’s esophagus (total peritoneal type) confirmed by gastroscopy and pathology were randomly divided into group A (n = 22) and group B (n = 22). Under argon gas flow rate (2L / min) and action time (3s), A group and B group were given 60 W output power and 70 W output power respectively, Postoperative proton pump inhibitor adjuvant therapy, 4 weeks after treatment, endoscopy and endoscopic ultrasound, esophageal repair and wall thickness were observed in 2 groups with or without stenosis. [Results] All patients completed the treatment. Gastroscopy was performed after 4 weeks. A group showed a smooth mucous membrane, some white scars were observed, and normal stenosis was observed. No obvious stenosis was observed in group B; gray mucous membrane color was found in group B, In group A, there was no significant change in the maximum thickness of the wall before treatment in group A (P> 0.05); Group B: the wall in the fourth week was significantly more than that before treatment Thickening (P <0.05), with statistical significance. [Conclusion] Concurrent esophageal scar stenosis can be avoided when the argon flow rate is 2L / min and the duration is 3s.