十二指肠溃疡愈合质量的内镜诊断及与复发的关系  

ENDOSCOPIC EVALUATION OF QUALITY OF ULCER HEALING AND CORRELA- TION WITH ULCER RELAPSE

作　　者：杨雪松[1] 李益农[1] 叶嗣懋[1] 林三仁[1] 吕愈敏[1] 

机构地区：[1]北京医科大学第三医院消化科,100083

出　　处：《中华消化内镜杂志》1996年第6期327-329,共3页Chinese Journal of Digestive Endoscopy

摘　　要：为探讨内镜对十二指肠溃疡的愈合质量的诊断价值及愈合质量与复发的关系，应用内镜下色素染色技术，将溃疡瘢痕分为Ｓａ、Ｓｂ、Ｓｃ三期，并对活动期溃疡病人分别给予阿莫西林、甲氰咪胍及阿莫西林加甲氰咪胍联合治疗。结果：Ｓａ期溃疡瘢痕较Ｓｂ 和Ｓｃ期更容易复发，Ｓｃ期无一例复发；甲氰咪胍组Ｓａ期比例有高于其它两组的趋势，且甲氰咪胍组两年溃疡复发率明显高于其它两组。研究表明，改善溃疡愈合质量可减少复发。To study the value of endoscopy in diagnosis of duodenal ulcer (DU)healing quality and correlation of QOUH (quality of ulcer healing)with ulcer recurrence. Using chromatoendoscopy ,the en- doscopic pattern of ulcer scar were evaluated according to Sa ,Sb and Sc stage. 55 cases of DU patients in active stage proved by endoscopy were randomly divided into 3 groups , group A was treated with amoxycillin (A)0. 5 tid ,group C was treated with cimetidine (C ) 800mg qn and group A+C was treated with A 0. 5 tid +C 800mg qn respectively for 4 weeks. Patients were followed- up by endoscopy to find ulcer recurrence. Results ,The 4 week ulcer healing rates were not significantly different among the three groups (P>0. 05 ). The Hp clearence and eradication rates had no significant differences beteween group A and A+C. The ratio of Sb pattern in group C were significgntly lower than that in group A and A+ C (P<0. 05) ,and the ratio of Sa pattern in group C seems higher than that in group A and A+C(P> 0. 05). Follow-up study showed that endoscopic pattern of ulcer scar was closely related with ulcere re- lapse ,Sa pattern was easily to relapse than Sb and Sc stage , and no relapse in Sc stage. The recurrence rate of group C was 65% within 2 years ,significantly higher than that of group A and A +C. lmproving QOUH could decrease ulcer relapse. The quality of ulcer healing after treated with A and A + C were better than C ,and the ulcer recurrence rates were also lower than that of group C.

关 键 词：十二指肠溃疡 溃疡愈合质量 内镜下色素染色 溃疡复发 阿莫西林 

分 类 号：R616.2[医药卫生—外科学]