黏膜切除术及氩离子凝固术治疗胃粘膜脱垂症-中国实用医刊.资料.doc

黏膜切除术及氩离子凝固术治疗胃粘膜脱垂摘要：目的：探讨内镜Edoscopic mucosal resection, EMR)及氩离子凝固术( argon plasma coagulation, APC)在治疗胃粘膜脱垂gastric mucosa prolapse，GMP）中的作用。方法：胃镜确诊105例胃粘膜脱垂随机标准EMR组(例)(40例)和对照组(33例)；治疗组术后及对照组采用内科药物治疗4周；1月后行症状随访及胃镜复查，进行疗效评价。结果：标准EMR组和对照组随访症状总有效率分别为%、90.00%和32.26%，(P0．01)；两治疗组比较差异无显著性(P0．05)。胃镜复查总有效率分别为％％16.7％；(P0．01)，两治疗组相比差异无显著性(P0．05)，但EMR组(92.10％)的显效比例高于APC组(73.00％)(P0．05)。结论：标准EMR治疗胃粘膜脱垂是一种安全、有效的微创治疗手段。【关键词】内镜胃粘膜脱垂Clinic study of gastric mucosa prolapse treated by endoscopic mucosal resection and argon plasma coagulation Wang Shu-jun* , Cao Xin-guang , Fang Li-feng , Wang Xiao-xia , Chen Hong-chao, Zhang Pu-xuan （he First People’S Hospital of Zhengzhou, Zhengzhou，450004, China）Abstract【Objective】To explore the effect of standard endoscopic mucosal resection（EMR）argon plasma coagulation(APC) for treatment of gastric mucosa prolapse. 【Methods】113 patients with prolapse of gastric mucosa diagnosed by gastroscopy were randomly divided into standard EMR group(n=40) ，APC group(n=40) and control group (n=33). Every patient had received medical therapy for 4 weeks. These patients were followed up the changes of symptoms and gastroscopy after 1 month. 【Results】 Compared with control group(32.26％)the total symptomatic efective rate of standard EMR group (94.87％) (90.00％)significantly increased (P001 )．And there were significant diferences between efective rate of endoscopic treatment group and that of control group(16.70％)(P0．01)，no significant diference between total EMR(97.37％)and APC group(91.89％)(P0．05)，while the proportion rate of endoscopic curative efect in EMR group(92．11％) was significantly superior to APC group(72.97％)(P0．O1). ．【Conclusions】 Standard EMR treatment of gastric mucosa prolapse is a safe and effective minimally invasive treatment. Key words: Endoscopic mucosal resection; Argon plasma coagulation; Gastric mucosa prolapsed 胃黏膜脱垂症gastric mucosa prolapse，GMP）是指异常松弛的胃窦黏膜向前通过幽门管脱入十二指肠球部，是消化道常见病之一，目前临床上缺乏有效的药物治疗方法 []。近年来内镜粘膜切除术Edoscopic mucosal resect