射频剥离与巴雷特食道中混合血凝结:一个潜在的随机试验
Mate Knabe1, Jens Wetzka2, Lukas Welsch3
1Department of Gastroenterology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany. Mate.Knabe@kgu.de.
混合血凝血 (H-APC) 与射频消化 (RFA) 相比,巴雷特食道的根除率略有改善. 与RFA相比,H-APC还导致术后疼痛明显减少,狭窄症也减少.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 在瘤学瘤学.
背景情况:
- 巴雷特食道是一种癌前疾病,需要在内镜切除后进行根除.
- 射频剥离 (RFA) 和混合血凝固 (H-APC) 是为此目的而建立的热剥离技术.
研究的目的:
- 为了比较巴雷特食道的RFA与H-APC的安全性,有效性和根除率.
- 为了评估两种废除方法之间的干预后疼痛和狭窄率.
主要方法:
- 一项随机对照试验比较H-APC和RFA在巴雷特食道内镜切除后的患者.
- 患者接受了H-APC (60W) 或RFA (各种协议).
- 在24个月的随访期间记录了消除率,不良事件,疼痛评分和需要干预的狭窄症.
主要成果:
- 总共有101名患者被纳入 (47名RFA,54名H-APC).
- 长期根除率为RFA的74.2%和H-APC的82.9%.
- 与H-APC (2.07/10,3.59天) 相比,RFA组的疼痛明显增加 (4.56/10,7.54天).
- 狭窄率为RFA的14.9%,而H-APC的3.7%.
结论:
- 无论是RFA还是H-APC,都显示了巴雷特食道的良好的根除率.
- 与RFA相比,H-APC具有略高的根除率,并显著减少了手术后的疼痛和狭窄.
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