经内镜氩离子凝固术联合抗幽门螺杆菌治疗隆起糜烂性胃炎的研究.doc

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1、经内镜氩离子凝固术联合抗幽门螺杆菌治疗隆起糜烂性胃炎的研究【摘要】目的研究应用氩离子凝固术（argonplasmacoagulation,APC）联合抗幽门螺杆菌治疗隆起糜烂性胃炎的价值及安全性。方法将98例隆起糜烂性胃炎患者随机分成A组（先药物后APC治疗组）和B组（药物+APC同时治疗组），比较两种方法的疗效。结果98例患者83例幽门螺杆菌阳性，35.7%（35/98）的患者发现肠上皮化生。在A组，单纯药物治疗仅有12.5%（6/48）的患者隆起糜烂性病变消失，而应用APC治疗后，90.5%（38/42）的患者隆起糜烂病变消失；在B组，隆起糜烂病

2、变治愈率达92.0%（46/50），与单纯药物治疗比较差异有显著统计学意义（P＜0.01）。APC治疗后仅2例出现黏膜下气肿，且在2周后自动吸收。11例出现轻微上腹胀或上腹隐痛，但均在术后2～3天消失。92例患者共进行了103次APC治疗，共治疗隆起糜烂性病变468个，平均每次治疗用时为12min。结论隆起糜烂性胃炎的发病与Hp感染有关，容易发生肠上皮化生。单纯药物治疗疗效欠佳。经内镜氩离子凝固术联合抗幽门螺杆菌治疗隆起糜烂性胃炎不仅疗效显著，而且安全简便。【关键词】内镜氩离子凝固术幽门螺杆菌隆起糜烂性胃炎Studyonprotuberanteros

3、ivegastritiswithendoscopicargonplasmacoagulation（APC）andanti-helicobacterpylori［Abstract］ObjectiveTostudytheefficacyandsafetyoftheAPCandanti-helicobacterpyloriappliedinpatientswithprotuberanterosivegastritis.Methods98patientssufferingfromprotuberanterosivegastritisweredividedin

4、totwogroups.GroupA:treatedonlywithdrugsfirstly,thenbyAPC;GroupB:treatedbyAPCanddrugssimultaneouslyandtheefficacyandsafetywerecompared.ResultsHelicobacterpylori（Hp）positiveratewas84.7%（83/98）,intestinalmetaplasiawasfoundin35.7%（35/98）patients.IngroupA:treatedonlywithdrugs,12.5%（

5、6/48）patientswereverifiedthattheprotrudinglesionsdisappeared,butaftertreatedwithAPC,（38/42）90.5%protrudinglesionsvanished;ingroupB:curerateoftheprotrudinglesionswas92.0%（46/50）,significantlyhigherthanthepatientsonlytreatedwithdrugs（P＜0.01）.Only2casespatientswithsubcutaneousemph

6、ysemadisappearedwithoutanytreatmentafter2weeks.11casespatientshadabdominalpainordistentionwhichstartedwithin1～2dafteroperationanddisappearedwithin2～3d.103timesofAPCweredoneand468protrudinglesionsweretreatedbyAPCin92patients,theaverageoperationtimewas12min.ConclusionHpinfectionp

7、layaroleinthepathogenesisofprotuberanterosivegastritis,intestinalmetaplasiawasfoundfrequentlyinprotrudinglesion.Protuberanterosivegastritistreated5withonlydrugshasnosignificanteffect,APCandanti-Hphaveexcellentefficacyandsafetyinthetreatmentofprotuberanterosivegastritis.［Keyword

8、s］endoscopy;argonplasmacoagulation;helicobacterpylori;