【摘要】 目的 探讨放大染色胃镜下氩气刀(APC)在治疗胃黏膜隆起糜烂的临床效果及价值。方法 应用放大内镜结合美蓝染色，对胃炎伴隆起糜烂的患者进行胃黏膜细微结构形态学观察，将胃小凹为D、E和F型的80例患者纳入治疗，应用APC9800型氩气刀对病灶进行治疗，观察治疗的临床结果及价值，并于治疗后1月放大染色胃镜复查随访疗效。结果 APC治疗胃黏膜隆起糜烂病灶384处，每个患者平均4.3处，1个月后复查随访，73例(91.25%)临床症状明显改善，经放大染色胃镜复查发现，68例(85%)患者病灶基本消除，原病灶处均覆盖新生的黏膜上皮及肉芽组织，胃小凹为A、B型的患者57例(83.82%)，胃小凹为C型的患者11例(16.18%)，7例(8.75%)患者仍有症状，镜下观察胃小凹仍为D、E和F型，需要再次APC治疗。APC治疗后部分患者出现上腹部隐痛、腹胀等症状，2～3天后可消失，并无其它严重并发症发生。结论 放大染色胃镜能准确识别胃小凹的形态，使APC更能准确地治疗胃黏膜隆起糜烂病灶，治疗效果肯定，操作简便。
【关键词】 胃黏膜;胃小凹;胃炎;氩气刀;胃镜检查
Magnifying chromogastroscopic plasma coagulation in treatment of gastric protrusive erosion
TANG Shao-bo, YUAN Hai-feng, XI Jin-yao, WANG Mei-li
(Department of Gastroenterology, the Affiliated Ruikang Hospital, Guangxi Traditional Chinese Medical College, Nanning, Guangxi 530011, China)
Abstract: Objective To evaluate the clinical efficacy and value of magnifying chromogastroscopic plasma coagulation (APC) in treatment of gastric protrusive erosion. Methods Magnifying endoscope in combination with methylene blue staining were used to observe the micro-structures of gastric mucosa in patients with gastric protrusive erosion. 80 cases with gastric pit types D, E and F were treated with APC-9800. Observed the clinical results and value of APC. One month after treatment, the patients were once more observed under magnifying chromogastroscopy and evaluated clinical effects. Results APC had treated 384 foci of gastric protrusive erosion, with an average of 4.3 foci in each patient. A one-month follow-up showed that 73 cases (91.25%) with ameliorated symptoms, while 68 cases (85%) of them were with good results (free symptoms), the original foci were covered with new mucosal epithelium and granulation tissues. 57 patients (83.82%) were with gastric pit types A and B, 11 cases (16.18%) with gastric pit type C, 7 cases (8.75%) of the patients still had symptoms. The patients, who still had gastric pit types D, E and F with repeatedly magnify
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