溃疡与胃炎。

Ulcers and gastritis.

作者信息

Kashiwagi H

机构信息

Dept. of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Kashiwa-shita, Kashiaw City, Chiba, Japan.

出版信息

Endoscopy. 2005 Feb;37(2):110-5. doi: 10.1055/s-2004-826147.

Abstract

This article reviews recently published reports on ulcers and gastritis. Helicobacter pylori is known to be an important pathogen involved in gastroduodenal inflammation and peptic ulcers. Conventional endoscopy is of limited usefulness in the evaluation of gastritis, but magnifying endoscopy is evidently helpful in the diagnosis of chronic atrophic gastritis, intestinal metaplasia, and H. pylori infection. A significant reduction in the incidence of refractory ulcers and the prevalence of H. pylori infection in patients with peptic ulcer disease followed the introduction of H. pylori eradication treatment. Chronic H. pylori infection is associated with gastric cancer, and the effect of H. pylori eradication on the prevention of gastric cancer is an important issue that is still a matter of controversy. Endoscopic hemostasis and intravenous proton-pump inhibitor (PPI) infusion represent a widely accepted approach to the treatment of peptic ulcer bleeding. In clinical practice, it is important to prevent recurrent bleeding and to treat patients who do not respond to endoscopic therapy or PPI treatment. Laparoscopic repair for peptic ulcer perforations, with postoperative eradication treatment, has gradually met with acceptance in patients with H. pylori infection. H. pylori infection and its treatment continue to be interesting problems in this field.

摘要

本文综述了最近发表的关于溃疡和胃炎的报告。幽门螺杆菌是已知参与胃十二指肠炎症和消化性溃疡的重要病原体。传统内镜检查在评估胃炎方面作用有限,但放大内镜检查显然有助于诊断慢性萎缩性胃炎、肠化生和幽门螺杆菌感染。随着幽门螺杆菌根除治疗的引入,消化性溃疡疾病患者中难治性溃疡的发病率和幽门螺杆菌感染率显著降低。慢性幽门螺杆菌感染与胃癌有关,幽门螺杆菌根除对预防胃癌的作用是一个仍存在争议的重要问题。内镜止血和静脉注射质子泵抑制剂(PPI)是治疗消化性溃疡出血广泛接受的方法。在临床实践中,预防再出血以及治疗对内镜治疗或PPI治疗无反应的患者很重要。对于幽门螺杆菌感染的患者,采用术后根除治疗的腹腔镜修补消化性溃疡穿孔已逐渐被接受。幽门螺杆菌感染及其治疗仍然是该领域中有趣的问题。

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