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经皮内镜胃造瘘术进行肠内营养是否会减弱幽门螺杆菌定植?值得一提吗?

Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

机构信息

Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey.

Giresun University, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2023 Apr 21;69(4):e20221733. doi: 10.1590/1806-9282.20221733. eCollection 2023.

Abstract

OBJECTIVE

In patients who experience difficulties in oral feeding, alimentary intake can be supported by creating direct access into the stomach through a percutaneous endoscopic gastrostomy. The present study purposed to compare naïve and exchanged percutaneous endoscopic gastrostomy tubes in terms of Helicobacter pylori infection and other clinical characteristics.

METHODS

A total of 96 cases who underwent naïve or exchanged percutaneous endoscopic gastrostomy procedures with various indications were incorporated into the study. The patients' demographic data, such as age and gender, etiology of percutaneous endoscopic gastrostomy, anti-HBs status, Helicobacter pylori status, the presence of atrophy and intestinal metaplasia, biochemical parameters, and lipid profiles, had been analyzed. In addition, the anti-HCV and anti-HIV statuses had also been evaluated.

RESULTS

The most common indication for percutaneous endoscopic gastrostomy placement was dementia in 26 (27.08%) cases (p=0.033). The presence of Helicobacter pylori positivity was significantly lower in the exchange group compared to the naïve group (p=0.022). Total protein, albumin, and lymphocyte levels were significantly higher in the exchange group compared to the naïve group (both p=0.001), and the mean calcium, hemoglobin, and hematocrit levels were statistically significantly higher in the exchange group (p<0.001).

CONCLUSION

Preliminary outcomes of the present study revealed that enteral nutrition attenuates the incidence of Helicobacter pylori infection. Considering the acute-phase reactant, the significantly lower ferritin values in the exchange group suggest that there is no active inflammatory process in the patients and that immunity is sufficient.

摘要

目的

对于存在经口进食困难的患者,可以通过经皮内镜胃造口术建立直接进入胃部的通道来支持摄食。本研究旨在比较初次和更换的经皮内镜胃造瘘管在幽门螺杆菌感染和其他临床特征方面的差异。

方法

共纳入 96 例因各种适应证而接受初次或更换经皮内镜胃造瘘术的患者。分析了患者的人口统计学数据,如年龄和性别、经皮内镜胃造瘘术的病因、抗-HBs 状态、幽门螺杆菌状态、萎缩和肠化生的存在、生化参数和血脂谱,此外还评估了抗-HCV 和抗-HIV 状态。

结果

经皮内镜胃造瘘术最常见的适应证是痴呆,共 26 例(27.08%)(p=0.033)。与初次组相比,更换组的幽门螺杆菌阳性率显著降低(p=0.022)。与初次组相比,更换组的总蛋白、白蛋白和淋巴细胞水平显著升高(均 p=0.001),且更换组的平均钙、血红蛋白和血细胞比容水平显著升高(均 p<0.001)。

结论

本研究的初步结果表明,肠内营养可降低幽门螺杆菌感染的发生率。考虑到急性期反应物,更换组的铁蛋白值明显较低,提示患者无活跃的炎症过程,且免疫充足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05ba/10176647/d82a8c79c90c/1806-9282-ramb-69-04-e20221733-gf01.jpg

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