幽门螺杆菌感染与食管癌切除术颈部吻合口瘘愈合时间的临床探讨  

Relationship between Helicobacter Pylori Infection and Healing Time of Cervical Anastomotic Leakage after Esophageal Cancer Resection

作　　者：史传文 董瑶 李庆云 SHI Chuanwen;DONG Yao;LI Qingyun(Taishan Vocational College of Nursing,Shandong,China,271000;Taishan Hospital,Shandong,China,271000)

机构地区：[1]泰山护理职业学院医学技术系,山东泰安271000 [2]山东省泰山医院,山东泰安271000

出　　处：《食管疾病》2023年第3期181-184,共4页Journal of Esophageal Diseases

摘　　要：目的探讨幽门螺杆菌(helicobacter pylori,HP)感染对食管癌切除术颈部吻合口瘘愈合时间的影响。方法回顾性分析食管癌切除术后颈部吻合口瘘患者临床资料,根据术前胃镜活检HP检测结果分为HP阳性组与HP阴性组,发现吻合口瘘后禁食12 h,取瘘出液测pH值及白细胞计数,记录吻合口瘘愈合时间,随访患者12个月内吻合口溃疡发生率。结果与HP阴性组比较,HP阳性患者吻合口瘘的愈合时间明显延长(P=0.0415),吻合口瘘出液的pH值显著减低(P=0.0243),瘘出液白细胞计数HP阳性组明显高于HP阴性组,有统计学差异(P=0.0357)。12个月内吻合口溃疡发生率HP阳性组较阴性组显著升高(P=0.0273)。结论HP可能通过炎症反应、局部代谢及微环境改变影响吻合口组织愈合过程,延长愈合时间,对有发生吻合口瘘高危风险的手术患者同时行HP根除治疗或将使患者受益。Objective To investigate the influence of HP infection on the healing time of cervical anastomotic leakage after esophageal carcinoma resection.Methods A retrospective analysis was conducted on the clinical data of patients with cervical anastomotic fistula after esophageal cancer resection.According to the HP test results of preoperative gastroscopy biopsy,the patients were divided into HP positive group and HP negative group.After discovering anastomotic leakage,they fasted for 12 hours,and the pH value and white blood cell count of the leakage effluent were measured.The healing time of the anastomotic leakage was recorded,and the incidence of anastomotic ulcer was followed up within 12 months.Results Compared with the HP negative group,the healing time of anastomotic fistula in HP positive patients was significantly longer(P=0.0415),and the pH value of anastomotic fistula effluent was significantly reduced(P=0.0243).The white blood cell count in the HP positive group was significantly higher than that in the HP negative group,with a statistical difference(P=0.0357).The incidence of anastomotic ulcer within 12 months was significantly more in the HP positive group than that in the negative group(P=0.0273).Conclusion HP may affect the healing process of anastomotic tissue through inflammatory reactions,local metabolism,and microenvironment changes,prolonging the healing time.For surgical patients at high risk of developing anastomotic fistula,simultaneous HP eradication treatment may benefit patients.

关 键 词：食管癌 吻合口瘘 愈合时间 幽门螺杆菌 

分 类 号：R735.34[医药卫生—肿瘤]