内镜注射EGF快速治愈消化性溃疡的研究

Endoscopic local injectin of hEGF and gentamycin in rapid therapy of peptic ulcer

目的研究 EGF(hEGF)及庆大霉素经内镜注射治疗消化性溃疡(PU)并幽门螺杆菌(Hp)感染的效果以及对 Hp 的根除率。方法在内镜下行溃疡清创后,在 PU 的外缘正常胃粘膜内注射 hEGF 100 μg/2 ml;把庆大霉素(Gen)16万 U+0.5%procain2ml+anisodamini 10 mg 共8 ml 复合液多点注射到胃窦幽门前一圈,皆1次/周,直到PU 愈合至内镜 S 期止。Hp 根除的金标准为两者(酶、菌)均阴性达1个月。胃内局部抑酸、杀 Hp 为主;全身系统抑酸、杀 Hp 为辅,即两原同治(酸、菌),两结合(局部、系统)的治疗方法。结果经内镜局部以及全身抑酸、杀菌后,HD 阳性 PU 100例的平均治愈时间(±s)12.8±6.7 d(其中 GU 32例±s)=14.7±7.0 d;DU 68例±s=11.9±6.0 d)。Hp根除率为91.0%。PU 治愈后1年内的复发率为9.0%。PU 治愈到内镜瘢痕愈合期(S_1-S_2)的快慢与溃疡的数目及其大小无关。PU 复发与溃疡治愈而 Hp 未根除有关。结论 hEGF 与 Gen 局部注射联合周身治疗 PU 并 Hp 感染是很有效的方法。其疗程短,疗效高,复发率低。

AIMS Human epidemal growth factor(hEGF)and gentamycin (Gen)locally were used to treat peptic ulcer(PU)complicated with Helicobacter pylori(Hp)infection endoscopically. METHODS From June 1991 to June 1994,100 consecutive pa- tients were diagnosed as PU by endnoscopy,of whom 86 were males,14 females,mean age of 41 years old,68 patients were duodenal ulcer,32 gastric ulcer.All PU were complicated with Hp infection.Human EGF 100 ∴g/2 ml were injected into mu- cosa around PU and Gen 160000 U+0.5% procain 2 ml+aniso- damini 10 mg were injected into the mucosa of gastric antrum once a week to kill Hp.At the same time,systematic treatment was used to inhibit acid secretion(20 mg omeprazole×7 d)and killing Hp(5 g of ampicillin,intravenously 1/d×7 d;120 mg of De-No1,orally 3/d×7 d). RESULTS The healing time of PU was 12.8±6.7 d(GU 32,14. 7±7.0d;DU 68,11.9±6.0d).Hperadication rate was 91. 0%.PU relapse rate in one year was 9.0%. CONCLUSIONS The local injection of hEGF might promote the healing of PU.The eradication rate of Hp is higher.The re- lapse rate is lower.This therapy is safe,reliable,free from side effects and easy to use in clinical practice.