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专家对上消化道内镜检查期间幽门螺杆菌感染检测及后续根除治疗的看法。

Experts' Perceptions Regarding Testing for Helicobacter pylori Infection During Upper Gastrointestinal Endoscopy and Subsequent Eradication Therapy.

作者信息

Kim Ilsoo, Lee Sang Pyo, Kim Jeong Wook, Kim Heung Up, Kim Tae Ho, Kim Seung Young, Kim Yu Jin, Moon Hee Seok, Lee Jung In, Shin Woon Geon

机构信息

Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Internal Medicine, Hanyang University Seoul Hospital, College of Medicine, Hanyang University, Seoul, Korea.

出版信息

Korean J Helicobacter Up Gastrointest Res. 2025 Mar;25(1):81-86. doi: 10.7704/kjhugr.2024.0073. Epub 2025 Mar 7.

Abstract

Helicobacter pylori causes gastric cancer and peptic ulcers, and eradication therapy can reduce the incidence of cancer in high-risk groups. In Korea, discrepancies between the reimbursement criteria and clinical guidelines create clinical challenges. This study investigated the perceptions and practices of experts regarding H. pylori testing during upper gastrointestinal endoscopy and any subsequent eradication therapy. An anonymous 8-question survey was conducted among 51 experts attending the 2024 Korean College of Helicobacter and Upper Gastrointestinal Research Summer Workshop. Only 2% of the experts tested all patients. Testing was performed in 54% of patients with a family history of gastric cancer, 32% of those with atrophic gastritis, 42% of those with dyspeptic symptoms, and 62% of those with iron-deficiency anemia. Among patients with suspected infections (based on endoscopic findings) and eligible for selective reimbursement, 82% underwent H. pylori testing. Age did not influence testing decisions for 60% of the experts, and 57% considered factors other than age when deciding on eradication therapy. The practices of the experts varied depending on the patient's clinical condition and economic burden. Aligning clinical guidelines with the reimbursement criteria is necessary to reduce confusion and ensure appropriate patient care.

摘要

幽门螺杆菌会引发胃癌和消化性溃疡,而根除疗法可以降低高危人群患癌的几率。在韩国,报销标准与临床指南之间的差异带来了临床挑战。本研究调查了专家在上消化道内镜检查期间对幽门螺杆菌检测以及后续根除疗法的看法和做法。对参加2024年韩国幽门螺杆菌与上消化道研究学会夏季研讨会的51位专家进行了一项包含8个问题的匿名调查。只有2%的专家对所有患者进行检测。有胃癌家族史的患者中54%接受了检测,萎缩性胃炎患者中32%接受了检测,有消化不良症状的患者中42%接受了检测,缺铁性贫血患者中62%接受了检测。在疑似感染(基于内镜检查结果)且符合选择性报销条件的患者中,82%接受了幽门螺杆菌检测。60%的专家表示年龄不影响检测决策,57%的专家在决定根除疗法时会考虑年龄以外的因素。专家的做法因患者的临床状况和经济负担而异。使临床指南与报销标准保持一致对于减少困惑和确保为患者提供适当护理是必要的。

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本文引用的文献

1
ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.美国胃肠病学会临床指南:幽门螺杆菌感染的治疗
Am J Gastroenterol. 2024 Sep 1;119(9):1730-1753. doi: 10.14309/ajg.0000000000002968. Epub 2024 Sep 4.
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Family History of Gastric Cancer and Treatment.胃癌家族史和治疗。
N Engl J Med. 2020 Jan 30;382(5):427-436. doi: 10.1056/NEJMoa1909666.

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