Hp根治治疗结合内镜球囊扩张术对消化性溃疡伴良性幽门梗阻患者疗效及预后的影响

Hp eradication therapy combined with endoscopic balloon dilatation for peptic ulcer and benign pyloric obstruction and its influence on patients' prognosis

目的:探讨幽门螺杆菌(Hp)根治治疗结合内镜球囊扩张术对消化性溃疡(PU)伴良性幽门梗阻患者疗效及预后的影响。方法:随机将90例消化溃疡伴良性幽门梗阻患者分为观察组与对照组,每组45例,对照组行常规内科治疗+内镜球囊扩张术,观察组在对照组基础上加以Hp根治治疗,比较两组临床疗效、Hp根除率、并发症及随访复发情况,测定两组治疗前、后血清白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平。结果:观察组治疗总有效率为93.33%,显著高于对照组的73.33%(P<0.50);治疗2周后两组血清IL-8、TNF-α水平均较治疗前显著下降(均P<0.05),且观察组上述指标均显著低于对照组(均P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);观察组治疗2周后Hp根除率明显高于对照组,随访6个月复发率明显低于对照组,差异有统计学意义(P<0.05)。结论:Hp根治方案能明显增强内镜球囊扩张术治疗PU伴良性幽门梗阻患者临床疗效,显著改善机体炎性反应,Hp清除率高且能明显降低幽门梗阻复发率。

Objective： To investigate the effect of Helicobacter pylori （Hp） eradication therapy combined with endoscopic balloon dilatation on peptic ulcer （PU） and benign pyloric obstruction and its influence on the prog- nosis of patients. Methods： A total of 90 patients with PU and benign pyloric obstruction were randomly divid- ed into an observation group and a control group, with 45 cases in each group. The patients in the control group received conventional medical treatment and endoscopic balloon dilatation, and those in the observation group were treated as the control group with addition of Hp eradication therapy. The clinical efficacy, Hp eradication rate, the incidence of complications and recurrence rate were compared between the two groups. The serum lev- els of interleukin-8 （IL-8） and tumor necrosis factor-α （TNF-α） were determined before and after treatment. Results： The total effective rate in the observation group was significantly higher than that in the control group （93.33% vs. 73.33%） （P〈0. 05）. After 2 weeks of treatment, serum IL-8 and TNF-α levels were significantly decreased in both groups （P〈0. 05）, and the IL-8 and TNF-α levels were significantly lower in observation group than those in the control group （P〈 0.05）. There was no significant difference between the two groups in the incidence of complications （P〉 0. 05）. The Hp eradication rate in the observation group after 2 weeks of treatment was significantly higher than that in the control group, while the recurrence rate during 6 months of fol- low-up was significantly lower（P〈0. 05）. Conclusion： Hp eradication therapy could obviously enhance the clinical effect of endoscopic balloon dilation in the treatment of PU combined with benign pyloric obstruction, and significantly relieve the inflammatory response, as evidence by high eradication rate of Hp and low recur- rence rate of pyloric obstruction.