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[挪威关于更新消化性溃疡中幽门螺杆菌治疗方法的会议。胃肠病学兴趣小组]

[A Norwegian conference on updating of the treatment of Helicobacter pylori in peptic ulcer. Interessegruppe for Gastroenterologi].

出版信息

Tidsskr Nor Laegeforen. 1994 Sep 10;114(21):2495-7.

PMID:7940453
Abstract

Recent data on peptic ulcer and Helicobacter pylori colonization of the ventricle were discussed. Agreement was reached to re-adjust the pharmacological treatment of this condition. All patients for whom antibiotic therapy is considered should be examined by gastroscope. The bacterial agent should be proved by at least one out of several available methods. Two different established regimens are prescribed, either triple therapy with bismuth, metronidazole and tetracycline or double treatment without bismuth, for instance amoxicillin and omeprazole. Clinical control should take place after about eight weeks, with a "breath-test" in the case of duodenal ulcers, or with gastroscopy and a urease test. Many pointed out that treatment aimed at gastric acid reduction is to be preferred in cases of first occurrence of ventricular ulcers. Long-term acid reduction by drugs should not be offered to a patient until an attempt has been made to eradicate existing bacteria. No patient should be operated on before he being given antibacterial treatment. Treatment of non-ulcer dyspepsia with antibiotics has not shown to have an affect.

摘要

讨论了有关消化性溃疡和胃内幽门螺杆菌定植的最新数据。就重新调整这种疾病的药物治疗达成了共识。所有考虑进行抗生素治疗的患者都应接受胃镜检查。应通过几种可用方法中的至少一种来证实细菌病原体。规定了两种不同的既定治疗方案,即铋剂、甲硝唑和四环素的三联疗法或不含铋剂的双联疗法,例如阿莫西林和奥美拉唑。临床控制应在大约八周后进行,十二指肠溃疡患者进行“呼气试验”,或进行胃镜检查和尿素酶试验。许多人指出,对于首次发生胃内溃疡的情况,首选旨在减少胃酸的治疗。在尝试根除现有细菌之前,不应向患者提供长期药物性胃酸减少治疗。在给予抗菌治疗之前,任何患者都不应接受手术。用抗生素治疗非溃疡性消化不良尚未显示有效果。

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