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[胃溃疡和十二指肠溃疡]

[Gastric ulcer and duodenal ulcer].

作者信息

Miyamoto Masaki, Haruma Ken

机构信息

Department of General Internal Medicine, Hiroshima Prefectural Hospital.

出版信息

Nihon Rinsho. 2013 Aug;71(8):1418-23.

Abstract

Peptic ulcer diseases are improved by strong acid suppression therapy. However, peptic ulcer diseases are often relapsed after discontinuing of acid suppression therapy. After discovery of Helicobacter pylori (H. pylori) in 1984, H. pylori is known as the strongest causal agent for peptic ulcer diseases. In November 2000, eradication therapy for H. pylori infection was approved under the Japanese system of health insurance. H. pylori eradication reduces ulcer recurrence dramatically. Recently, peptic ulcer diseases induced by NSAIDs and/or aspirin are increasing. In prevention of NSAIDs and/or aspirin induced peptic ulcer recurrence, H. pylori eradication plus PPI treatment is recommended. Several reports described occurrence of newly-developed gastric cancer after H. pylori eradication. Careful follow-up upper gastrointestinal endoscopy is necessary after H. pylori eradication.

摘要

强力抑酸疗法可改善消化性溃疡疾病。然而,在停止抑酸治疗后,消化性溃疡疾病常常复发。自1984年发现幽门螺杆菌(H. pylori)后,幽门螺杆菌被认为是消化性溃疡疾病最主要的致病因素。2000年11月,幽门螺杆菌感染的根除疗法在日本医疗保险体系下获得批准。根除幽门螺杆菌可显著降低溃疡复发率。近年来,由非甾体抗炎药(NSAIDs)和/或阿司匹林引起的消化性溃疡疾病正在增加。在预防NSAIDs和/或阿司匹林引起的消化性溃疡复发方面,推荐采用根除幽门螺杆菌加质子泵抑制剂(PPI)治疗。有几份报告描述了幽门螺杆菌根除后新发胃癌的发生情况。幽门螺杆菌根除后,需要仔细进行上消化道内镜随访。

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