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残胃的幽门螺杆菌及其根除

Helicobacter pylori of the remnant stomach and its eradication.

作者信息

Rino Y, Imada T, Shiozawa M, Takahashi M, Fukuzawa K, Hasuo K, Nagano A, Tanaka J, Hatori S, Amano T, Kondo J

机构信息

First Department of Surgery, Yokohama City University School of Medicine, Japan.

出版信息

Hepatogastroenterology. 1999 May-Jun;46(27):2069-73.

Abstract

BACKGROUND/AIMS: Many authors have reported that Helicobacter pylori (H. pylori) is one of the major causes of gastritis and peptic ulcer. This study was conducted to evaluate the incidence of H. pylori infection and the curative effects of amoxicillin and omeprazole on H. pylori in the remnant stomach.

METHODOLOGY

Biopsy specimens were obtained from 70 patients who underwent gastrectomy for gastric cancer. H. pylori was subsequently diagnosed by CLO test and culture of H. pylori. Gastritis was assessed by the scoring of four characteristic pathological parameters. Patients with positive H. pylori were eligible for the eradication study. Amoxicillin, 750 mg per day for 2 weeks, and omeprazole, 20 mg per day for 8 weeks, were administered to them. Endoscopic reexamination was performed 12 weeks after the initiation of treatment.

RESULTS

The overall positive rate of H. pylori was 37.1%; 39.6% in Billroth I reconstruction, 0% in Billroth II reconstruction, and 55.6% in pylorus preserving gastrectomy, respectively. The positive H. pylori rate of Billroth II reconstruction was significantly low. However, there was no association of positive rate of H. pylori with time. There was no significant difference of gastritis scores between H. pylori infected patients and non-infected patients. The eradication rate was 70.0%.

CONCLUSIONS

H. pylori was present in 37.1% of patients who underwent gastrectomy. Gastritis was not significantly severe in H. pylori infected patients. The treatment with amoxicillin and omeprazole was effective for these patients.

摘要

背景/目的:许多作者报道幽门螺杆菌(H. pylori)是胃炎和消化性溃疡的主要病因之一。本研究旨在评估幽门螺杆菌感染的发生率以及阿莫西林和奥美拉唑对残胃中幽门螺杆菌的治疗效果。

方法

从70例因胃癌接受胃切除术的患者中获取活检标本。随后通过CLO试验和幽门螺杆菌培养诊断幽门螺杆菌。通过对四个特征性病理参数进行评分来评估胃炎。幽门螺杆菌阳性的患者符合根除研究的条件。给予他们每天750毫克阿莫西林,持续2周,以及每天20毫克奥美拉唑,持续8周。治疗开始12周后进行内镜复查。

结果

幽门螺杆菌的总体阳性率为37.1%;毕Ⅰ式重建中为39.6%,毕Ⅱ式重建中为0%,保留幽门胃切除术中为55.6%。毕Ⅱ式重建的幽门螺杆菌阳性率显著较低。然而,幽门螺杆菌阳性率与时间无关联。幽门螺杆菌感染患者和未感染患者的胃炎评分无显著差异。根除率为70.0%。

结论

在接受胃切除术的患者中,37.1%存在幽门螺杆菌。幽门螺杆菌感染患者的胃炎并不显著严重。阿莫西林和奥美拉唑治疗对这些患者有效。

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