气囊扩张和根除幽门螺杆菌治疗幽门梗阻

Endoscopic balloon dilation and Helicobacter pylori eradication for treatment of pyloric stenosis

目的 前瞻性观察经内镜气囊扩张和根除Hp对十二指肠球部溃疡并幽门梗阻预后的影响。方法 十二指肠球部溃疡并幽门梗阻用TTS气囊扩张 ,Hp感染用尿素酶、组织学和血抗体测定 ,根除Hp用14 C尿素呼气试验。结果 2 1例均成功经内镜气囊扩张而无并发症 ,最后气囊直径 :12mm 10例 ,15mm 8例 ,18mm 3例 ,4例需重复扩张者为严重狭窄。 18例 (85 7% )诊断为可能有Hp感染 ,而行 1周四联根除细菌治疗 ,平均随访 13月 ,无复发。余 3例未行根除者中 2例短期内复发而行外科切除 ,1例服抑酸剂无复发。结论 气囊扩张和根除Hp治疗对十二指肠球部溃疡并幽门梗阻有较好的效果。

Aim To determine the safety and efficacy of endoscopic balloon dilation and H.pylori eradication for treatment of duodenal ulcer accompanied with pylori stenosis.Methods Twenty-one patients underwent through-the-scope balloon dilation for pyloric stenosis,and H.pylori infection was determined using the rapid urease test,histology and serology.Results All 21 patients underwent successful dilation,of which dilation to at least 12 mm was in 10 patients,15 mm in 8,and 18 mm in 3 patients.Four individuals required more than one session,and 17 patients had a single procedure with symptoms immediate relief.At the median follow-up of 13 months,18 patients whose H.pylori were eradicated successfully remained asymptomatic,while other 2 patients without H.pylori eradication had a recurrent obstruction and required subsequent surgery.Conclusion The endoscopic balloon dilation is safe and effective,and H.pylori eradication improves the long-term efficacy for the treatment of duodenal ulcer induced pyloric stenosis.