胃镜下高频电凝联合幽门螺杆菌根除疗法治疗疣状胃炎的疗效观察  

Therapeutic observation of high-frequency electric coagulation under endoscope combined eradication of helicobacter pylori in patients with varioliform gastritis

作　　者：黄家淼[1] 王利娜[1] 胡维杰[1] 汪晓俊[1] 

机构地区：[1]解放军八一医院消化科,江苏南京210002

出　　处：《中国内镜杂志》2007年第7期731-734,共4页China Journal of Endoscopy

摘　　要：目的探讨胃镜下高频电凝联合幽门螺杆菌(Hp)根除疗法治疗疣状胃炎(VG)的近期和远期疗效。方法经胃镜诊断且Hp阳性的212例VG患者按胃镜检查先后顺序分为A、B两组,每组106例。A组在胃镜下对所有成熟型疣状病变行高频电凝治疗,术后予Hp根除治疗;B组仅予Hp根除治疗。比较两组患者疗程结束后4周时Hp根除率和疣状病变治愈率、6个月时疣状病变的治愈率和长期随访过程中的癌变率。结果A、B组分别有1例和2例因药物过敏反应退出试验。6个月时A、B两组各有5例和4例失访。两组Hp根除率分别为92.4%(97/105)和93.3%(97/104),差异无显著性(P>0.05)。A、B两组疗程结束后4周时成熟型疣状隆起的治愈率分别为95.4%(248/260)和6.9%(17/245)(P<0.001),6个月后成熟型疣状隆起的治愈率分别为87.1%(216/248)和19.6%(46/235)(P<0.001),差异均有非常显著性。A、B两组分别随访(41.2±15.5)个月和(41.7±15.2)个月,A组癌变率为0,B组癌变率为6%(6/100),两组比较差异有显著性(P<0.05)。结论Hp根除疗法对成熟型疣状隆起的逆转疗效差,胃镜下高频电凝联合Hp根除疗法治疗成熟型疣状隆起近期和远期疗效显著。能否减少癌变的发生,还有待大样本的进一步研究。[ Objective ] To discuss the therapeutic effects of high-frequency electric coagulation under endoscope combined with eradication of Helicobacter pylori （H pylori） on varioliform gastritis （VG）. [Methods] 212 cases of VG with H pylori infection were devided into 2 equal groups. The patients in group A were treated with H pylori eradication combined with high-frequency electric coagulation on complete type verruciod focus under endoscope, while those in group B received therapy of eradication of H pylori only. Endoscope and biopsy were performed and the disappearance of verruciform protuberance was observed 4 weeks and 6 months after cessation of treatment respectively. All patients were followed-up. [Results] Three patients （1 in group A, 2 in group B） were withdrawn for the allergic reaction of drugs. And nine patients were dropped out 6 month later （5 in group A, 4 in group B）. The eradication rates of H pylori in group A （92.4%） and group B （93.3%） had no significant difference （P 〉0.05）. The disappearance rates of the complete type verrucoid focus in group A were significantly higher than those in group B [4 weeks later： 95.4% （248/260） vs 6.9% （17/245）, 6 months later： 87.1% （216/248） vs 19.6% （46/235）, all P 〈 0.001]. Followed-up average （41.2±15.5） months in group A and （41.7±15.2） months in group B, incidence of cancer were 0 in group A and 6.0% （6/100） in group B with significant difference between them （P 〈0.05）. [Conclusions] The eradication of H pylori is ineffective for complete type focus in patients with VG. The high-frequency electric coagulation under endoscope combined with eradication of H pylori is effective for complete type verruriform protuberance not only in short-terms but in long-term. It needs more samples to study whether the combination treatment could reduce the incidence of cancer.

关 键 词：疣状胃炎 癌前状态 治疗 

分 类 号：R573.3[医药卫生—消化系统]