EAS法评估PPI联合黏膜保护剂对ESD术后溃疡愈合的影响

摘要

Objective To evaluate the effect of teprenone combined with esomeprazole on ulcer healing after gastric ESD with endoscope assistant softwares.Methods Sixty-nine cases of early gastric cancer treated by gastric ESD were divided randomly into drug combination group and PPI group.Patients in drug combination group were given teprenone combined with esomeprazole, while patients in PPI group were given PPI group alone.The treatment course was 4 weeks.Ulcer healing after ESD were evaluated with EAS.Ulcer healing and the rate of complication in the two groups were compared.Results No delayed bleeding was occurred in drug combination group and no intraoperative or postoperative perforation were occurred in the two groups.The stage and area of ulcer had no differences after 2 weeks of ESD, while showed a better healing stage and smaller area in drug combination group after 4 weeks of ESD(P<0.05).Conclusion Teprenone combined with esomeprazole can effectively promote post ESD ulcer healing, especially reducing the rate of complication after gastric ESD.EAS is helpful to evaluate the effect on ulcer healing after gastric ESD.%目的 利用计算机视觉测量软件法(EAS)对艾司奥美拉唑联合替普瑞酮治疗内镜黏膜下剥离术(ESD)后溃疡疗效的评价.方法 选取69例行胃 ESD 治疗的患者,随机数字表法分为药物联合组35例、质子泵抑制剂(PPI)组34例.药物联合组给予艾司奥美拉唑联合替普瑞酮治疗,PPI组仅给予艾司奥美拉唑治疗,疗程均为4 周.应用EAS法评价两组患者术后2周及术后4周溃疡愈合情况及并发症发生率.结果 药物联合组无迟发性出血的发生,两组均未出现术中及术后穿孔.ESD 术后2周两组溃疡分期、溃疡面积比较差异无统计学意义;术后4周药物联合组溃疡愈合级别高于PPI组(P<0.05) ,药物联合组溃疡面积小于PPI组(P<0.05).结论 艾司奥美拉唑联合替普瑞酮能有效提高ESD术后溃疡愈合的质量,减少术后并发症的发生率.EAS法有利于ESD术后溃疡愈合疗效的评价.