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首页 > 医学词汇大全 > Argon Plasma Coagulation
Argon Plasma Coagulation

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关键词消化 手术操作 食管胃肠手术

词汇介绍

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解析

argon  英 [ˈɑːɡɒn] 美 [ˈɑːrɡɑːn]

释义   n. [化学] 氩(18号元素)

例句   The effect of nitrogen can be overcome by sheathing the flame in argon. 氮的影响则可以通过用氩气包覆火焰而予以克服。

 

plasma 英 [ˈplæzmə] 美 [ˈplæzmə]

释义   n. [等离子] 等离子体;血浆;[矿物] 深绿玉髓

例句   One Plasma to bind them. 等离子把他们联系在一起。

 

coagulation  英 [kəʊ,æɡjʊ'leɪʃən] 美 [koʊˌæɡjuˈleɪʃn]

释义   n. 凝固,凝结;凝结物

例句   The ultrafiltration rate of pure water with the coagulation bath temperature increased. 纯水的超滤率随凝固浴温度的升高而增大


概述

氩离子凝固术(argon plasma coagulation,APC)是一种非接触性电凝固技术,其原理是利用特殊装置将氩气离子化,氩气通过离子化传导由钨丝电极产生的高频电能,继而能量被传导至组织而产生凝固效应。APC装置由一个高频电能发生器,一个氩气源及探头(内径1.5mm,外径2.0mm),一根远端陶瓷管口内装有钨丝电极的可屈式纤维Teflon管组成,此管可以通过内镜的钳道。 适应症(1)食管疾病,包括Barrett's食管、晚期食管癌恶性狭窄、食管内支架置入后网眼和支架上下端

Radiofrequency ablation compared with argon plasma coagulation after endoscopic resection of high-grade dysplasia or stage T1 adenocarcinoma in Barrett's esophagus: a randomized pilot study (BRIDE)复制标题

Barrett食管高度异型增生或T1期腺癌内镜切除术后射频消融与氩等离子凝固的比较: 一项随机初步研究 (BRIDE)

发表时间:2019-04-25

影响因子:7.2

作者: Mohammad Farhad Peerally

期刊:Gastrointestinal Endoscopy

The most important element of endoscopic therapy is endoscopic resection (ER), which targets macroscopically visible lesions, providing accurate staging information6,7  and successful management.8,9 However, ER targets only visible abnormalities, leaving BE in which dysplasia could recur.10 Metachronous dysplasia occurs in up to 30% of  residual BE after ER10 but not if all BE is removed by stepwise repeated ER, although esophageal stenosis is frequent (>80% in a recent randomized trial [RCT]).11 Ablative techniques, including thermal methods such as argon plasma coagulation (APC)12-14 and radiofrequency ablation (RFA)15,16 offer an alternative strategy. Both are effective in case series and RCTs, with the strongest evidence for RFA. Shaheen et al,17 in a multicenter RCT comparing RFA with sham, found dysplasia clearance at 1 year of 81% in patients with HGD. Large prospective series have shown similar results.18-20 Efficacy of APC in clearance of dysplastic and nondysplastic BE has been demonstrated in small case series12-14,21,22 and recently in an RCT comparing APC with surveillance of residual BE after ER for HGD or intramucosal cancer: metachronous lesions occurred in 3% after APC compared with 36% after 24 months’ surveillance.23 RFA has been more extensively investigated17,20,24,25and has a standardized methodology developed from in vitro and animal studies,26 allowing a predictable burn depth,27 and extensive clinical  experience from U.K. and U.S. registries has shown a good safety profile.18,19,28,29 APC is cheaper and widely available but is less standardized.

译文

内窥镜治疗的最重要要素是内镜切除术(ER),它针对肉眼可见的病变,提供准确的分期信息6,7和成功的治疗方法。8,9然而,ER仅针对可见的异常,从而使异型增生症复发。10 ER10术后高达30%的残余BE发生异型增生,但如果通过逐步重复的ER去除所有BE则不会发生,尽管食管狭窄是常见的(最近的一项随机试验[RCT]> 80%)。11包括热疗在内的消融技术诸如氩等离子体凝结(APC)12-14和射频消融(RFA)15,16之类的方法提供了另一种策略。两者在病例系列和RCT中均有效,RFA证据最充分。 Shaheen等[17]在多中心RCT中比较了RFA和假手术,发现HGD患者在1年时异型清除率为81%。大量的前瞻性研究结果相似。18-20在小病例系列研究中证明了APC在清除增生和非增生BE中的功效12-14,21,22,最近在一项RCT中,比较了APC和ER进行HGD后残留BE的监测黏膜内或黏膜内癌:APC后发生异时性病变的发生率为3%,而监测24个月后为36%。23RFA的研究更加广泛[17,20,24,25],并且具有通过体外和动物研究开发的标准化方法,26可预测的烧伤深度[27]以及来自英国和美国注册管理机构的广泛临床经验显示出良好的安全性。[18,19,28,29] APC较便宜且广泛使用,但标准化程度较低。