目的 :探讨食管上皮重度不典型增生的诊治方法。方法 :口服H2 受体拮抗剂雷尼替丁或质子泵抑制剂奥美拉唑与促胃动力药西沙比利和粘膜保护剂硫糖铝联合用药 ,定期复查 ,随访 2年。结果 :1例食管狭窄梗阻手术 ,1例癌变手术 ,1例Barret食管手术 ,1 6例病理恢复正常 ,4例病理检查有所恢复 ,总有效率 86.9%。结论 :对于食管上皮重度不典型增生 ,进行严格内科治疗 ,去除致病因素 ,定期复查 ,在防止癌变方面具有重要意义。对于癌变或有梗阻症状及Barret食管应手术治疗。 Objective: To explore the diagnosis and treatment of severe dysplasia of esophageal epithelium. METHODS: Oral administration of oral ranidomide or proton pump inhibitor omeprazole was used in combination with cisapride, a proton pump inhibitor, and sucralfate, a mucosal protective agent. The patients were followed up for 2 years. Results: 1 case of esophageal stenosis obstruction surgery, 1 case of cancerous surgery, 1 case of Barret’s esophagectomy, 16 cases of normal pathological recovery, 4 cases of pathological examination have been restored, the total effective rate was 86.9%. Conclusion: For severe dysplasia of esophageal epithelium, strict medical treatment, removal of pathogenic factors, and regular review are important in preventing canceration. For cancerous or obstructive symptoms and Barret esophagus should be treated surgically.