Ghosh Tamal Kanti, Ghoshal U C, Chakraborty Srikanta
Department of Pathology, Burdwan Medical College, Burdwan.
Indian J Pathol Microbiol. 2002 Jan;45(1):83-7.
31 patients of peptic ulcer (PU) treated in the past by vagotomy with Gastrojejunostomy (GJ)/pyloroplasty, later presented with dyspesia. These postvagotomy dyspeptic patients were investigated. Antral and corpus endoscopic biopsies were taken to evaluate for Helicobacter pylori (Hp) infection by inhouse rapid urease test (RUT), histopathological examination and scanning electron microscopy (SEM). Dyspepsia score was done in both pre and post treatment phase. Hp positive patients were randomised to receive anti H. pylori therapy. Hp eradication was recorded by repeat RUT and endoscopic biopsy followed by SEM. Coccoid form of Hp were detected in 76.92% cases of vagotomy with gastrojejunostomy (GJ) and coccobacillary forms of Hp were seen in 75% cases of pyloroplasty. After treatment with anti Hp therapy coccoid forms persisted in 69.23% of GJ cases, whereas 22% of pyloroplasty cases showed coccoid transformation. Anti Hp therapy did not reveal any statistically significant improvement in 'Dyspepsia Score' in GJ group, whereas it improved significantly in pyloroplasty group (p=0.002).
31例既往接受过迷走神经切断术加胃空肠吻合术/幽门成形术治疗的消化性溃疡（PU）患者，后来出现了消化不良症状。对这些迷走神经切断术后的消化不良患者进行了调查。取胃窦和胃体的内镜活检组织，通过内部快速尿素酶试验（RUT）、组织病理学检查和扫描电子显微镜（SEM）评估幽门螺杆菌（Hp）感染情况。在治疗前和治疗后阶段都进行了消化不良评分。Hp阳性患者被随机分配接受抗Hp治疗。通过重复RUT和内镜活检，随后进行SEM来记录Hp的根除情况。在胃空肠吻合术的迷走神经切断术病例中，76.92%的病例检测到Hp的球菌形态，在幽门成形术病例中，75%的病例可见Hp的球杆菌形态。抗Hp治疗后，胃空肠吻合术病例中有69.23%的球菌形态持续存在，而幽门成形术病例中有22%出现球菌转化。抗Hp治疗在胃空肠吻合术组的“消化不良评分”中未显示出任何统计学上的显著改善，而在幽门成形术组中则有显著改善（p = 0.002）。
