根除幽门螺杆菌联合球囊扩张术治疗良性幽门梗阻合并消化性溃疡患者的临床疗效与安全性评价

Clinical efficacy and safety of eradication of Helicobacter pylori combined with balloon dilation in the treatment of benign pyloric obstruction complicated with peptic ulcer

目的评价根除幽门螺杆菌(Helicobacter pylori,H.pylori)联合球囊扩张术治疗良性幽门梗阻合并消化性溃疡(peptic ulcer,PU)患者的临床疗效与安全性。方法选取上海市杨浦区中心医院2012年5月-2013年5月收治的78例良性幽门梗阻合并PU患者,使用随机数字表分为观察组、对照组,各39例,均给予常规对症支持及球囊扩张术治疗,观察组加用根除H.pylori治疗。比较两组患者治疗效果、复发情况及并发症发生情况,评价治疗方案的临床疗效与安全性。结果两组患者住院时间、治疗费用比较,差异无统计学意义(P>0.05)。观察组39例患者复查H.pylori均为阴性。观察组临床总有效率高于对照组(94.87%vs66.67%),复发率低于对照组(5.13%vs 28.21%),差异有统计学意义(P<0.05)。两组患者治疗期间均未见穿孔、胃出血等严重并发症发生。结论在常规治疗及球囊扩张术的基础上,根除H.pylori能够进一步保证治疗效果、降低患者术后再狭窄风险,其良好的临床疗效与安全性值得肯定,建议推广。

Objective To evaluate the clinical efficacy and safety of eradication of Helicobacter pylori （H. pylori） combined with balloon dilation in the treatment of benign pyloric obstruction complicated with peptic ulcer （PU）. Methods Seventy-eight cases of benign pyloric obstruction complicated with PU in our hospital from May. 2012 to May. 2013, were collected, and divided into the observation group and the control group. The two groups were given routine symptomatic support and balloon dilatation therapy,the observation group was treated with H. pylori eradication therapy. The clinical efficacy and safety of two groups were compared, and the clinical efficacy and safety of the treatment were evaluated. Results There was no significant difference in the length of stay and treatment cost between two groups （P 〉 0.05）. In the observation group, 39 cases were negative for H. pylori. The clinical total effective rate of observation group was higher than that of control group, the recurrence rate was lower than that in the control group, the difference was statistically significant （P 〈 0.05 ）. There were no serious complications such as perforation, bleeding and other serious complications in the two groups. Conclusion On the basis of routine treatment and balloon dilatation, the eradication of H. pylori can further ensure the treatment effect, reduce the postoperative risk of restenosis, the good clinical efficacy and safety of worthy of recognition, it is proposed to popularize.