浅析残胃病变与胆汁反流及幽门螺杆菌感染的相关性  

simple correlation analysis of residual stomach lesions with bile reflux andhelicobacter pylori infection

作　　者：党叶川 

机构地区：[1]河南科技大学附属三门峡市中心医院,河南三门峡472000

出　　处：《临床研究》2017年第8期17-18,共2页Clinical Research

摘　　要：目的 探讨胃大部分切除术后残胃病变同幽门螺杆菌感染与胆汁反流的相关性.方法 选取2014 年1 月至2016 年5 月期间本院普外科收治的行胃大部分切除术患者56 例,所有患者均存在不同程度残胃病变,对其幽门螺杆菌感染和胆汁反流发生情况进行观察分析.结果 胃癌患者胆汁反流与Hp 感染发生率均明显高于胃溃疡、残胃炎患者,差异具有显著性（P 〈 0.05）;胃溃疡患者胆汁反流、Hp 感染发生率均明显高于残胃炎患者,差异具有显著性（P 〈 0.05）;毕Ⅰ式患者Hp 感染发生率明显高于毕Ⅱ式,毕Ⅱ式患者胆汁反流发生率明显高于毕Ⅰ式者,差异具有显著性（P 〈 0.05）.结论 幽门螺杆菌感染和胆汁反流同胃大部切除术后患者残胃病变的发生、发展密切相关,其中毕Ⅰ式由于胃体切除部分较少,同毕Ⅱ式相比患者术后面临着更高的幽门螺杆菌感染风险,在临床治疗过程中应准确把握适应症,合理选择术式,对幽门螺杆菌感染和胆汁反流进行有效治疗,从而有效预防残胃病变,促进患者生存质量的提高.Objective To investigate the correlation between gastric remnant lesion and Helicobacter pylori （Hp） infectionand bile reflux after subtotal gastrectomy. Methods From January 2014 to May 2016, a total of 56 patients undergoing subtotalgastrectomy in the general surgery department of our hospital was recruited into the study, all patients demonstrated differentdegree of gastric remnant lesions, the incidence of Hp infection and bile reflux were detected and analyzed. Results whencompared with the patients with gastric ulcer and gastritis patients, both the incidence rate of bile reflux and the Hp infectionin patients with gastric cancer were significantly higher （P 〈 0.05）; the incidence rate of bile reflux and the Hp infection inpatients with gastric ulcer was significantly higher than that of patients with residual gastritis （P 〈 0.05）; the incidence rate ofHp infection in patients undergoing Billroth I subtotal gastrectomy was significantly higher than that of patients undergoingBillroth II subtotal gastrectomy, while the incidence rate of bile reflux in patients undergoing Billroth II subtotal gastrectomywas significantly higher than that of patients undergoing Billroth I subtotal gastrectomy （P 〈 0.05）. Conclusion Hp infectionand bile reflux in patients with subtotal gastrectomy is closely related to the occurrence and development of gastric remnantlesion. Due to the less gastric resection, the patients undergoing Billroth I gastrectomy were confronted with higher risks ofHp infection when compared with the patients undergoing Billroth II gastrectomy. During the clinical therapeutic process,more attention should be paid to selecting the indication and the operation type, selection of operation, the anti-Hp therapy andbile reflux therapy could prevent the progression of gastric remnant lesions and improve the quality of life of the patients.

关 键 词：胃大部分切除术 残胃病变 幽门螺杆菌感染 胆汁反流 

分 类 号：R573[医药卫生—消化系统]