残胃病变与胆汁反流及幽门螺杆菌感染的相关性临床分析  

Clinical analysis of correlation between bile reflux Helicobacter pylori infections and residual gastropathy

作　　者：伍小青[1] 刘慧燕[2] 陈晓君[3] 

机构地区：[1]江山市人民医院消化内科,浙江江山324100 [2]江山市人民医院外科,浙江江山324100 [3]江山市人民医院内科,浙江江山324100

出　　处：《中华医院感染学杂志》2013年第10期2398-2399,2402,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨胆汁反流及幽门螺杆菌感染在胃大部切除术后残胃病变发生、发展中的作用。方法回顾性调查2008年10月-2010年10月普外科行胃大部切除术后并发残胃病变患者42例临床资料,分析患者胆汁反流及幽门螺杆菌感染情况。结果残胃病变中胆汁反流占57.1%;幽门螺杆菌阳性占40.5%,胃癌、胃溃疡和残胃炎各组之间胆汁反流和幽门螺杆菌感染发生率具有统计学差异(P<0.05);毕Ⅱ式胆汁反流的发生率显著高于毕Ⅰ式(P<0.05),而幽门螺杆菌感染率显著低于毕Ⅰ式(P<0.05);术后1年内胆汁反流和幽门螺杆菌感染发生率分别为31.8%和27.3%,显著低于1年后的85.0%和55.0%(P<0.05)。结论合理选择术式避免胆汁反流,积极治疗幽门螺杆菌感染是预防胃大部分切除术后残胃病变的有效方法。OBJECTIVE To investigate the clinical significance of bile reflux and Helicobacter pylori infections in patients with residual gastropathy. METHODS From Oct 2008 to Oct 2010,a total of 42 patients with residual gastropathy after subtotal gastrectomy were retrospectively analyzed in the hospital, and the incidence of the bile reflux and the H. pylori infections were analyzed. RESULTS The incidence of bile reflux and H. pylori infections were 57.1% and 37. 1%, respectively. The incidence of bile reflux and H. pylori infections were statistically different among the patients with gastric cancer, gastric ulcer, gastritis group（P〈0.05）. The incidence of bile reflux was higher in the Billroth Ⅱ -type than that in the Billroth Ⅰ-type（P〈0.05）. However, The incidence of H. pylori infections was lower in the Billroth Ⅱ -type than that in the Billroth Ⅰ -type（P〈0.05）. The incidence of bile reflux（85.0% vs 31.8%） and H. priori infections （55.0% vs 27.3%） were higher in the patients with longer than one year treatment than in the patients with less than one year treatment（P〈0.05）. CONCLUSION To choose the reasonable surgery approach to prevent the bile reflux and to actively treat the H. pylori infections are effective ways to prevent the residual gastropathy after subtotal gastrectomy.

关 键 词：残胃病变 胆汁反流 幽门螺杆菌 

分 类 号：R573[医药卫生—消化系统]