内镜下射频消融术治疗食管和胃低级别上皮内瘤变的临床研究

内镜下射频消融术治疗食管和胃低级别上皮内瘤变的临床研究
·14·中华胃肠内镜电子杂志2015年2月第2卷第1期Chin J Gastrointestinal Endoscopy（Electronic Edition），February2015，Vol．2，No．1
·论著·内镜下射频消融术治疗食管和胃低级别
上皮内瘤变的临床研究
令狐恩强冯佳马晓冰王向东朱静孟江云杜红王红斌张晓彬
【摘要】目的探讨内镜下射频消融术治疗食管和胃的低级别上皮内瘤变的有效性及安全性。

方法回顾性分析解放军总医院消化内镜中心2014年10月至2015年1月行内镜检查，经病理证实
为食管或胃低级别上皮内瘤变的21例患者纳入研究，经门诊行内镜下射频消融治疗，其中食管部病
变射频消融2次，胃部病变射频消融3次，术后采用Wang-Baker 面部表情量表进行疼痛评分，治疗后
1个月进行内镜复查。

结果21例共计31个低级别上皮内瘤变病灶纳入研究。

16例共计23个低级
别上皮内瘤变病灶进行了复查，其中14例患者，21个病灶经射频治疗后消失，病灶消除率91．30%
（21/23）；2例患者2个低级别上皮内瘤变病灶出现残留，病灶残留率8．70%（2/23）。

16例复查患者
病灶治疗部位黏膜均愈合，术后腹痛为主要并发症。

结论内镜下射频消融术治疗食管和胃低级别
上皮内瘤变是安全、有效、并发症小、可门诊治疗的一种新方法。

【关键词】内窥镜检查；低级别上皮内瘤变；射频消融术；食管；胃
Clinical study of endoscopic radiofrequency ablation for treatment of low-grade gastroesophageal
intraepithelial neoplasia Linghu Enqiang，Feng Jia，Ma
Xiaobin，Wang Xiangdong，Zhu Jing，Meng
Jiangyun，Du Hong，Wang Hongbin，Zhang Xiaobin．Department of Gastroenterolgy，Chinese PLA General Hospital，Beijing100853，China
Corresponding author：Linghu Enqiang，Email：linghuenqiang@vip．sina．com
【Abstract】Objective To evaluate the efficacy and safety of radiofrequency ablation（ＲFA）for
esophageal and gastric low-grade intraepithelial neoplasia （LIN）．Methods We retrospectively enrolled21
patients with LIN of esophagus and stomach who were treated withＲFA under endoscopic at the General
Hospital of PLA from October2014to January2015．Two pulses were used to ablate the esophageal lesions
and three pulses were used to ablate the gastric lesions．Pain scores were recorded using Wang-Baker facial pain scale．A month later，patients underwent regular endoscopy follow-ups．Ｒesults A total of31LIN
lesions of21patients were included in the study．Twenty-three lesions of16patients underwent endoscopy
follow-ups after1month．The lesions elimination rate was91．30%（21/23）and the lesions residual rate was 8．70%（2/23）．TheＲFA treatment lesions of16patients healed by endoscopy follow-up and postoperative
pain was the main complications．ConclusionＲFA is considered to be safe and effective，which can be
performed in the outpatient service．
【Key words】Endoscopy；Low-grade intraepithelial neoplasia；Ｒadiofrequency ablation；
Esophagus；Stomach
随着上消化道内镜检查技术的开展，食管和胃
DOI：10．3877/cma．j．issn．2095-7157．2015．01．004
基金项目：北京市科技计划课题（D141000*********）
作者单位：100853北京，解放军总医院消化内科
通讯作者：令狐恩强，Email：linghuenqiang@vip．sina．com
作者简介：令狐恩强（1963－），博士，科主任，主任医师，教授，主要从事消化系统疾病的内镜下治疗研究。

低级别上皮内瘤变（low-grade intraepithelial neoplasia，LIN）的检出率也越来越高。

对于消化道的高级别瘤变内镜下黏膜切除术（endoscopic mucosal resection，EMＲ）、内镜下黏膜剥离术（endoscopic submucosal dissection，ESD）等已经成为目前主要的治疗方法，而对于低级别上皮内瘤变按照维也纳胃肠道上皮肿瘤的诊疗指南［1］，应进行随。