摘要
目的:通过对残胃粘膜幽门螺杆菌(Hp)感染情况的检测分析,探讨残胃病变与Hp感染的关系。方法:回顾分析1990 -2003年间3 479例残胃患者(残胃组)和3 400例同期患者(对照组)的胃镜及病理检查、Hp检测情况,对两组Hp感染率进行比较,同时对残胃组的不同年龄、性别、术后随访时间、手术方式、有否胆汁返流及各种残胃病变的Hp感染情况进行比较分析。结果:(1)残胃组Hp感染率为26.56%,明显低于对照组58.26%(P<0.01)。(2)残胃患者年龄越大.Hp感染率越低(P <0.01),而不同性别Hp感染率无显著差异(P>0.05)。(3)术后胃镜随访时间<6个月、6个月-5年、6-10年、11-20年、>20年,残胃患者Hp感染率分别为40.74%、32.93%、26.22%、10.89%、1.85%,各时间段比较,有显著差异(P<0.01) (4)Billroth Ⅰ式Hp感染率(37.62%)高于BillrothⅡ式和Roux-en-Y胃肠重建术式Hp感染率(19.12%、29.24%),3种术式比较,有显著差异(P<0.01)。(5)残胃炎、残胃溃疡、残胃癌变的Hp感染率分别为22.58%、61.12%、65.03%,前者与后两者比较,有显著差异(P<0.01)。(6)残胃伴及不伴胆汁返流者Hp感染率分别为7.49%、31.59%,两者差异显著(P<0.01)。结论:残胃患者Hp感染率低,且与年龄、手术术式、术后生存时间等相关,而与性别无关。残胃患者应定期行胃镜及病理检查?
Objective:To study the relationship of the remnant stomach and Hp infection by Hp detection of remnant gastric mucosa after partial gastrectomy. Methods: We retrospectivly studied the endoscopy with multiple biopsies,and Hp detection in 3 479 patients who underwent partial gastrectomy (resected group)and 3400 patients at same time(control group) from 1990 to 2003. The Hp positive rate in the two groups, and Hp infection status on the vary age, sex. postoperative time, operation methods, bile reflux and remnant stomach were compared and analyzed. Results: ( 1 ) The rate of Hp infection in the resected group was 26. 56%,which was lower than the rate of control group (58. 26 % ,P<0. 01). (2)The elder the age of patients with remnant stomach,the lower the rate of Hp infcction(P<0. 01). The rate of Hp infection in vary sex did not reach statistical significance in (P>. 05). (3) The rate of Hp infection of postoperative patients less than 6 months, from 6 mouther to 5 years,6-10 years, 11-20 years and more than 20 years was 40. 74% ,32. 93% ,26. 22% , 10. 89% and 1. 85.% respectively. The rate of Hp infection in various time period are significantly different. (P<0. 01). (4) The rate of Hp infection was higher in patients with Billroth Ⅰ (37.62%) reconstruction than in those with Billroth Ⅱ and Roux-en-Y type reconstructions (19. 12% . 29. 24%). There were significant difference in the 3 type reconstructions (P<0. 01). (5) The rate of Hp infection with gastritis of the remnant stomach and the anastomtic inflammation. Ulcer and cancer of the remnant stomach and anastomotic was 22. 58% .61. 12% and 65. 03% respectively. The difference reach statistical significance between the first and the last two (P 0. 01 ). (6) The rate of Hp infection with bile reflux was higher than that of without bile reflux (7. 49% vs 31. 59% ,P<0.01).. Conclusion: H. pylori infection was reduced in patients with gastric stump and related to age and operation methods, postoperative time:But no correlation of these factors with sex was found. Periodical surveillance for the patients who underwent partial gastrectomy with endoscopy plus multiple biopsies and selcetivly eradicate Hp in the remnant stomach is recommended.
出处
《中国临床医学》
北大核心
2005年第1期70-73,共4页
Chinese Journal of Clinical Medicine
