摘要
目的探讨胃大部切除术后残胃病变与幽门螺杆菌(Hp)感染的关系。方法采用快速尿素酶试验、组织切片W arth in-Starry银染及尿素呼气试验检测682例残胃病患者Hp感染情况,并进行流行病学分析。结果682例残胃病患者Hp感染检出率为27.42%,与年龄、性别以及术后时间无关;B illroth I式术后残胃Hp检出率(40.07%)明显高于B illroth II式术后残胃Hp检出率(17.37%),而伴有胆汁返流的残胃Hp感染阳性率(7.98%)明显低于不伴胆汁返流的残胃阳性率(33.53%)。同时,因溃疡、穿孔、出血行手术的残胃Hp检出率(47.88%)高于因胃癌手术的检出率(22.66%);不同病理学残胃中,残胃溃疡和残胃癌的Hp感染率明显高于慢性残胃炎及吻合口炎的Hp感染率。结论胃大部切除术后残胃病变与Hp感染密切相关,尤其是残胃癌,应及早进行Hp治疗,可减轻残胃病变,减少残胃癌的发生。
Objective To investigate the relationship between gastric remnant after subtotal gastrectomy and infection of Helicobacter pylori （Hp）. Methods A total of 682 patients with remnant stomach in Chongqing were subjected to gastroendoscopy and biopsy specimens were taken. Rapid ureasc test, PCR, histological study with Warthin-Starry staining and ELISA were used to detect Hp infection, and the results were subjected to epidemiological analysis. Results Hp infection was detected in 27.42% patients with remnant stomach. No correlation was found between Hp infection and age, sex and postoperative duration. The infection rate of Hp was significantly higher in those by Billroth Ⅰ reconstruction （40.07 % ） than those by Billroth Ⅱ （ 17.37 % ）, and in those without bile reflux （33.53 % ） than those with （7.98 % ）, in those undergoing operation due to peptic ulcer, stomach perforation and gastrorrhagia （47.88 % ） than those due to gastric cancer （22.66 % ）, and in those with ulcer and cancer in remnant stomach than those with chronic gastritis of the remnant stomach and infection of the anastomotic inflammation. Conclusion The lesion of gastric remnant is closely associated with Hp infection, especially in gastric residual cancer. Early treatment is recommended for Hp infection to reduce gastric residual lesion and decrease carcinogenesis in gastric remnant.
出处
《局解手术学杂志》
2006年第2期84-86,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
幽门螺杆菌
残胃
胃大部切除术
helicobacter pylori
gastric remnant
subtotal gastrectomy
