目的 观察内镜下高频电凝加PPI治疗岛型及舌型SSBE的近中期疗效及安全性.方法 经内镜及病理检查确诊的岛型及舌型SSBE病例39例,随机及自愿结合分组.23例治疗组患者在内镜下对岛型及舌型SSBE病灶施行高频电凝治疗,同时口服雷贝拉唑,20 mg,bid,疗程4周.16例对照组患者则单纯予雷贝拉唑口服,20 mg,bid,持续抑酸治疗.分别于治疗后第3个月、6个月、12个月、18个月及24个月行胃镜随访,对照原内镜图片,观察各组岛型及舌型SSBE病灶的变化,并在原病灶处取活组织检查其病理改变.对治疗组中复查内镜未达显效者,再次行镜下电凝治疗并予雷贝拉唑口服,20 mg,bid,疗程4周.结果 治疗组随访病例平均显效率87.6%,总有效率100%；未出现出血、穿孔及食管狭窄等并发症.对照组平均显效率6.6%,平均总有效率26.5%,平均无效率73.5%.结论 经内镜下高频电凝加PPI治疗岛型及舌型SSBE安全,近期疗效明显.%Objective To evaluate the efficacy of high-frequency electrocautery combined with PPI treatment on island-type and tongue-type short-segment Barrett's esophagus. Methods Thirty-nine patients with island -type or tongue -type SSBE diagnosed with endoscopy and biopsy were randomly divided into treatment group and control group. Treatment group were treated with high-frequency electrocautery combined with rabeprazole for 4 weeks. Control group were treated with rabeprazole only. All patients were received the endoscopic review and biopsy at 3, 6. 12, 18 and 24 months. If there was residual Barrett' s esophagus in treatment group, high-frequency electrocautery and rabeprazole was repeated. Results Total effective rate was 100％ in treatment group,while the total effective rate was only 26.5％ in control group. All patients who received high -frequency electrocautery were no complications. such as bleeding. perforation,esophagostenosis. Conclusion High-frequency electrocautery combined with rabeprazole therapy was efficacy and safe for island-type and tongue-type SSBE.
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