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目的:对Barrett食管(BE)患者进行氩离子凝固术(APC)和/或药物治疗,随访观察其疗效及安全性。方法:经胃镜及活检确诊的BE患者113例,随机分为3组,Ⅰ组:对照组,未给予治疗;Ⅱ组:口服奥美拉唑;Ⅲ组:行APC后并口服药物(同Ⅱ组)维持,3月后复查,若发现有残留BE,再次行APC治疗1次。所有患者治疗1年,并在治疗6月及12月时复查内镜并行活检,比较三组在治疗前后的临床症状、内镜及活检结果。结果:奥美拉唑治疗组与APC治疗加奥美拉唑组的临床症状均较治疗前明显改善,显著优于对照组。各组均未观察到严重不良反应。Ⅰ组与Ⅱ组BE的内镜下表现未见明显变化。Ⅲ组能使89.6%的BE达到内镜下完全消除,一年后复发率为25.6%,至随访结束时,完全缓解BE占治疗的66.7%。结论:单纯药物治疗仅能改善BE患者的症状;APC联合药物治疗既可改善BE患者的症状,也可消除BE,安全性好,但复发率较高。
OBJECTIVE: To evaluate the efficacy and safety of argon plasma coagulation (APC) and / or drug therapy in patients with Barrett’s esophagus (BE). Methods: 113 BE patients diagnosed by endoscopy and biopsy were randomly divided into 3 groups: group Ⅰ: control group without treatment; group Ⅱ: oral omeprazole; group Ⅲ: APC after oral administration (with Ⅱ Group) to maintain, review after March, if found to have residual BE, once again APC treatment. All patients were treated for 1 year, and endoscopic biopsy was performed in June and December of treatment. Clinical symptoms, endoscopy and biopsy results were compared between the three groups before and after treatment. Results: The clinical symptoms of omeprazole group and APC plus omeprazole group were significantly better than those before treatment, which were significantly better than the control group. No serious adverse reactions were observed in all groups. There was no significant change in the endoscopic findings of BE in group Ⅰ and group Ⅱ. In group Ⅲ, 89.6% of BEs were completely eliminated by endoscopy, with a recurrence rate of 25.6% after one year. By the end of follow-up, BE accounted for 66.7% of complete treatment. Conclusion: Simple drug treatment can only improve the symptoms of BE patients. APC combined with drug therapy can not only improve the symptoms of BE patients, but also eliminate BE, which is safe and has a high recurrence rate.