残胃幽门螺杆菌感染的临床特征及治疗

Clinical characteristics and treatment of the infection of helicobacter pylori in gastric stump

目的探讨残胃幽门螺杆菌感染的临床特征及治疗方法。方法回顾性分析进行残胃胃镜检查的210例及随机抽取同期无胃肠道手术病史进行胃镜检查并做Hp检测的200例患者的临床资料。结果残胃的Hp感染率为26．2％，不同手术原因Hp感染率比较差异无统计学意义，Billroth-Ⅰ式术后Hp阳性率明显高于毕Billroth-Ⅱ式手术后，有胆汁反流者Hp阳性率低于无胆汁反流，随着胃大部切除术后时间的延长，Hp的感染率愈来愈低，抗Hp的治疗转阴率为87．3％。结论残胃Hp感染率偏低，但Hp残胃病变加重，目前常用的抗Hp的治疗方案加用胃黏膜保护剂和胃动力药物适合于治疗残胃的Hp感染，有一定的临床应用价值。

Objective To investigate the clinical characteristics and the treatment of the infection of helicobacter pylori in gastric stump. Methods The clinical data of 210 patients who were examined by gastroscopy for gastric stump and 200 randomly selected patients who had no history of operation due to gastrointestinal diseases and received gastroscopy and Hp detections were retrospectively analyzed. Results The Hp infective rate in gastric stump was 26.2 %, and the Hp infective rates had no significant difference among different operative causes. The Hp positive rate after Billroth- Ⅰ operation was obviously higher than that after Billroth- Ⅱ type operation;the Hp positive rate in the patients with bile regurgitation was lower than that in the patients without bile regurgitation. The Hp infective rate became lower as the time after subtotal gastrectomy prolonged. The clearance rate of anti-Hp treatment was 87.3 %. Conclusion The Hp infective rate in gastric stump is lower, but the Hp lcsion in gastric stump is aggravated. The anti-Hp therapeutic program which is commonly used at present plus gastric mucosa protectant and gastric motive power drugs are suitable for treating Hp infection in gastric stump, and have definite value in clinical application.