影响溃疡愈合质量及复发因素的研究

Study on the influence factors to the quality of ulcerative healing and recurrence

为探讨影响十二指肠溃疡愈合质量 (QOUH)及复发的因素 ,对 2 5 3例胃镜确诊的幽门螺杆菌 (HP)阳性、十二指肠溃疡活动期患者进行 1年随访。结果表明 :完成治疗及随访的 2 2 9例患者溃疡愈合率 10 0 %。Sa期溃疡瘢痕较Sb和Sc期更易复发 ( P <0 .0 5 ) ,Sa期无一例复发。溃疡复发者HP( +)显著高于HP( -) ( P <0 .0 5 )。溃疡直径≥ 2 .1cm、线状和深凹陷溃疡治疗后溃疡瘢痕保持在Sc期者较溃疡直径≤ 2 .0cm、类圆形及星形、霜斑样、浅凹陷及凹陷的溃疡明显增多(P <0 .0 5 ) ,其复发率差异有高度显著性 (P <0 .0 1) ,且短期延长抑酸剂治疗时间并不能改善QOUH而降低溃疡复发。提示对HP( +)、线状的、深凹陷的或直径≥ 2 .1cm溃疡患者 ,应长期用抑酸剂维持治疗。

In order to study the influence factors to the quality of duodenal ulcer healing (QOUH) and its recurrence, the one year follow up for 253 patients with duodenal ulcer (positive HP) proven by gastroscope had been mede. Results showed that the ulcer healing rate was 100% in 229 patients after treatment and follow up. The ulcer scars were easily recurred in stageSa than stageSb and Sc (P<0.05), No ulcer scar recurred in stageSc. The ulcer recurrence rate in positive Hp group was higher than in negativeHP group (P<0.05). Patients with linear, deep dented ulcer that scars remained in stage Sc after treatment (with ulcer diameter ≥ 2.1cm) had more ulcer scars than those with rounded stellar, frost patch, dimple and pitting ulcer (with ulcer diameter ≤2.0cm )(P<0.05), there were statistical significant difference in recurrence rate (P<0.01), moreover, the QOUH will not be improved and the ulcer recurence will not be decreased by short-term prolonging the treatment time with acid-inhibited agent. It indicated that patients with the symtoms of positive HP, linear, deep dented or ulcer diameter ≥2.1cm should receive the long-term treatment with acid inhibited agent.