胃切除术后幽门螺杆菌感染的临床分析

Clinical analysis of Helicobacter pylori infection after gastrectomy

目的探讨胃大部分切除术后幽门螺杆菌(Hp)感染的临床分析及诊治对策,以降低感染发生率。方法回顾性分析2005-2013年行胃大部分切除术的207例患者的临床资料,研究该类患者幽门螺杆菌感染情况,并提出临床诊治对策。结果 207例患者中,Hp阳性检出84例,阳性检出率为40.58%;男性Hp阳性60例,阳性检出率为40.54%,女性Hp阳性24例,阳性检出率为40.68%,两者差异无统计学意义;≤40岁患者检出阳性31例,阳性检出率为29.52%,>40岁检出阳性53例,阳性检出率为51.96%,两者差异有统计学意义(P<0.05);毕罗Ⅰ式检出阳性68例,阳性检出率为51.52%,毕罗Ⅱ式检出阳性26例,阳性检出率为34.67%,差异有统计学意义(P<0.05)。结论胃大部切除术后,年龄偏高、采用毕罗Ⅰ式手术方式治疗的患者人群,是Hp的易感人群,对该类患者应加强Hp感染监控,一旦发生感染,立即采用三、四联疗法加以治疗。

OBJECTIVE To explore the related factors for the Helicobacter pylori （Hp） infection after gastrectomy and put forward diagnosis and treatment measures so as to reduce the infection rate. METHODS The clinical data of 207 cases of patients who underwent the gastrectomy from 2005 to 2013 were retrospectively analyzed, then the incidence of Hp infections was observed, and the diagnosis and treatment measures were formulated. RESULTS Among the 207 cases, 84 （40. 58M） cases were tested positive for Hp, including 60 （40. 54%） cases of male patients and 24 （40. 68%） cases of female, the difference was not statistically significant. Among the patients aged less than 40 years, 31 （29.52%） cases were tested positive for Hp; among the patients aged more than 40 years, 53 （51.96%） cases were tested positive for Hp, the difference was statistically significant （P〈0.05）, The Burt ROM type I has been detected positive in 68 cases with the positive rate of 51.52%, while the Butt ROM type Ⅱ has been detected positive in 26 cases with the positive rate of 34.67%, the difference was statisti- cally significant （P〈0.05）. CONCLUSION The old age and Burr ROM type I surgery are the risk factors for Hp infection in the patients undergoing subtotal gastrectomy, it is necessary to strengthen the monitoring of Hp infec-tion, and once the infection occurs, the trigeminy or quadruple therapy should be taken immediately.