胃部分切除术后监控幽门螺旋杆菌的临床研究

Clinical Study on the Monitoring of Helicobacter Pylori After Partial Gastrectomy

目的分析胃部分切除术后残胃病变与幽门螺旋杆菌（Hp）感染之间的关系。方法对我院2013年6月至2015年3月收治的120例残胃病变行胃部分切除术患者为研究对象,术后对所有患者行Hp检测,包括：快速尿素酶试验（RUT）以及碳13呼气试验,观察不同类型胃疾病术后Hp检出率、不同病变残胃的Hp检出率、不同年龄段残胃Hp检出率、不同性别残胃Hp检出率、残胃胆汁返流与Hp感染发生情况。结果胃癌患者的Hp检出阳性率显著低于胃溃疡、穿孔、出血患者（21.54%vs45.45%）,差异具有统计学意义（χ^2=7.768,P〈0.05）。残胃炎、吻合口炎患者的Hp检出阳性率明显低于残胃溃疡和残胃癌患者,差异具有统计学意义（P〈0.05）。有胆汁返流患者Hp检出阳性率显著低于无胆汁返流者（19.61%vs 42.03%）,差异具有统计学意义（χ^2=6.720,P〈0.05）。不同年龄段和不同性别患者Hp检出阳性率比较均无显著差异（P〉0.05）。结论胃部分切除术后残胃病变与Hp感染密切相关,尤其是残胃癌,应及早进行Hp治疗,从而减轻残胃病变,减少残胃癌的发生。

Objective To study the relationship between gastric remnant lesion and Helicobacter pylori（Hp） after partial gastrectomy.Methods 1 20 cases of gastric remnant lesion patients implemented partial gastrectomy in our hospital from June 201 3 to March 201 5 were selected and given Hp detection, including rapid urease test（R U T） and carbon 1 3 breath test. The Hp detection rate of different types of gastric diseases, different gastric remnant lesions, different ages, different gender and different situations of gastric remnant bile reflux were observed. Results The Hp positive rate of patients with gastric carcinoma was lower than that of patients with gastric ulcer, gastric perforation, gastric bleeding（21.54% vs 45.45%）, with statistical difference（χ^2 = 7.768, P〈0.05）. The Hp positive rate of patients with residual gastritis and anastomositis were lower than those of patients with gastric remnant ulcer, gastric remnant carcinoma, the difference was statistical（P〈0.05）. The Hp positive rate of patients with bile reflux was lower than that of patients without bile reflux（1 9.61 % vs42.03%）, with statistical difference（χ^2 = 6.720, P〈0.05）. The Hp positive rate of patients in different ages and different gender had no statistical difference（P〉0.05）. Conclusions The gastric remnant lesion is closely related to Hp infection after partial gastrectomy, especially gastric remnant carcinoma. Hp treatment should be carried out as soon as possible, which can reduce the gastric remnant lesion and reduce the incidence of gastric remnant cancer.