四联疗法根除幽门螺杆菌对胃黏膜剥离术后溃疡愈合的作用  

Efficacy of 2-week standard quadruple therapy and sequential treatment for post-endoscopic submu-cosal dissection ulcer with Helicobacter pylori infection

作　　者：刘建强[1] 王雯[1] 王蓉[1] 李达周[1] 张志坚[1] 林克荣[1] 江传燊[1] 李海涛[1] 叶舟[1] 

机构地区：[1]南京军区福州总医院消化内科 福建医科大学福总临床医学院消化内科,福州350025

出　　处：《中华消化内镜杂志》2015年第11期747-750,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨四联疗法根除幽门螺杆菌（Hpylori）对内镜黏膜下剥离术（ESD）后溃疡愈合效果的作用。方法60例胃黏膜病变ESD术后的Hpylori感染患者，将纳入研究的序号按随机数字表法分为根除Hpylori组（30例）和对照组（30例），分别于手术4周、8周、12周后行胃镜检查，对比2组患者的溃疡大小、分期及瘢痕愈合率。结果ESD术后4周、8周复查胃镜，根除／4．pylori组的溃疡最大径、面积均小于对照组溃疡最大径、面积，而且根除H.pylori组的S1期愈合率高于对照组的S1期愈合率，但2组间的差异均无统计学意义。而ESD术后12周复查内镜，根除Hpylori组溃疡全部愈合，对照组仍有5例溃疡未达到瘢痕愈合，其溃疡最大径（2．0±4．3）mill和面积（21±48）mm2均显著大于根除Hpylori组，而且根除Hpylori组12周溃疡的瘢痕愈合率显著高于对照组（P〈0．05）。对2组8周和12周的溃疡分期分析，根除Hpylori组的整体溃疡愈合质量显著高于对照组（P〈0．05）。结论对行胃黏膜病变ESD术后的Hpylori感染患者，给予根除Hpylori治疗可有效促进ESD术后溃疡愈合，显著提高溃疡愈合率及溃疡愈合质量。Objective To evaluate the therapeutic efficacy of a 2-week standard quadruple therapy and sequential treatment for post endoscopic submucosal dissection （ESD） ulcer with Helicobacter Fylori （ H. Fylori） infection. Methods Sixty patients with H. pylori infection who underwent gastric ESD were divid- ed into the H. pylori eradication group （ n = 30） and the control group （ n = 30） according to the random num- ber table. The ulcer diameter and the ulcer healing rates at 4-wk and 8-wk and 12-wk were monitored and com- pared between the two groups. Results The ulcer diameter and area at 4-wk and 8-wk in the H. pylori eradication group were lower than those of the control group, but the scarfing rate of ulcers of S1 was higher than that of the control group with no significant difference. All the ulcers were scarfing healing in the H. Fylori eradication group at 12-wk, but 5 cases failed in the control group. The ulcer diameter（2. 0±4. 3）mm and ar- ea（21±48）mm^2 in the control group were significantly higher than those in the H. pylori eradication group at 12-wk. And the healing rate of ulcers in the H. pylori eradication group was significantly higher than that in the control group at 12-wk （ P 〈 0. 05 ）. The level and quality of the ulcer healing in the H. pylori eradication group were significantly higher than those in the control group （P 〈 0. 05 ）. Conclusion The 2-week standard quad- ruple therapy for H. pylori eradication could improve the level and quality of ulcer healing of the ESD-induced ulcers, and enhance the healing rate of ulcers in patients with H. pylori infection.

关 键 词：溃疡 螺杆菌 幽门 治疗结果 内镜黏膜下剥离术 

分 类 号：R573.1[医药卫生—消化系统]