Ueda Hiroyuki, Ito Masanori, Tanaka Shinji, Oka Shiro, Takata Shunsuke, Imagawa Shinobu, Xie Xue Fei, Yoshihara Masaharu, Haruma Ken, Chayama Kazuaki
Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, 734-8551, Japan.
J Clin Gastroenterol. 2006 Apr;40(4):293-6. doi: 10.1097/01.mcg.0000212600.38897.80.
It remains unclear whether Helicobacter pylori eradication therapy accelerates the healing of acute gastric ulcer after endoscopic mucosal resection (EMR) of gastric tumor. We examined the effect of H. pylori eradication therapy on ulcer healing after EMR.
Twenty-six patients who underwent successful H. pylori eradication therapy before EMR were followed prospectively. Patients underwent endoscopic examination 1 or 2 months after EMR, during which the ulcer status and reduction rate were assessed. The effect of H. pylori eradication on the quality of ulcer healing was also evaluated. Six patients in whom eradication therapy failed and 26 patients who underwent EMR without eradication therapy served as control subjects.
Endoscopically, 18 (75%) of 24 ulcers in the eradication group were at the healing stage 1 month after EMR. The ulcer reduction rates were 85.0 +/- 2.6% and 96. 9 +/- 1.1% at 1 and 2 months after EMR, respectively. Ulcer stage and reduction rate did not differ significantly between the eradication group and control group. However, we frequently observed a better quality of ulcer healing in the eradication group than in the control groups (P < 0.01).
H. pylori eradication therapy does not accelerate ulcer healing after EMR but may improve the quality of ulcer healing of gastric ulcer after EMR.
目前尚不清楚幽门螺杆菌根除治疗是否能加速胃肿瘤内镜黏膜切除术（EMR）后急性胃溃疡的愈合。我们研究了幽门螺杆菌根除治疗对EMR后溃疡愈合的影响。
对26例在EMR前成功进行幽门螺杆菌根除治疗的患者进行前瞻性随访。患者在EMR后1或2个月接受内镜检查，评估溃疡状态和缩小率。还评估了幽门螺杆菌根除对溃疡愈合质量的影响。6例根除治疗失败的患者和26例未进行根除治疗的EMR患者作为对照。
内镜检查显示，根除组24个溃疡中有18个（75%）在EMR后1个月处于愈合阶段。EMR后1个月和2个月的溃疡缩小率分别为85.0±2.6%和96.9±1.1%。根除组和对照组的溃疡分期和缩小率无显著差异。然而，我们经常观察到根除组的溃疡愈合质量优于对照组（P<0.01）。
幽门螺杆菌根除治疗不能加速EMR后溃疡的愈合，但可能改善EMR后胃溃疡的愈合质量。
