[摘要] 目的 判断根除幽门螺杆菌（Hp）对内镜下黏膜切除术（EMR）后溃疡愈合效果的观察。方法 方便选取80例2015年6月―2017年5月期间该院胃粘膜息肉合并有HP感染患者纳入研究，将80例患者随机按随机数字分为两组，HP根除组和安慰剂组各40例，分别于术后1、2、4周复查内镜。观察创面愈合情况。 结果 EMR术后1周，根除幽门螺杆菌组和安慰剂组的溃疡分期为活动期分别为10例和32例，根除幽门螺杆菌组分期显著优于安慰剂组。差异有统计学意义（P0.05）。术后4周，根除幽门螺杆菌组和安慰剂组在疤痕期分别为40例和32例，安慰剂组还有8例在愈合期。但差异无统计学意义（P>0.05）。结论 抗幽门螺旋杆菌治疗可以有效帮助EMR术后创面的愈合，显著提高病灶的愈合率。
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[关键词] 胃镜下粘膜切除术（EMR）；粘膜切除术后溃疡；幽门螺杆菌（Hp）
[中图分类号] R57 [文献标识码] A [文章编号] 1674-0742（2017）12（b）-0084-03
[Abstract] Objective To determine and observe the effect of anti-Helicobacter pylori treatment on ulcer healing after the endoscopic mucosal resection. Methods 80 cases of patients with gastric mucosa polyps combined with HP infection in our hospital from June 2015 to May 2017 were convenient selected and randomly divided into two groups with 40 cases in each， including the HP eradication group and placebo group， and the endoscope was reexamined in 1-week， 2-week and 4-week after operation， and the wound healing was observed. Results 10 cases and 32 cases were respectively in the active stage in the HP group and in the placebo group in 1 week after EMR surgery， which showed that the staging in the HP group was obviously better than that in the placebo group， and the difference was statistically significant（P0.05）， and 40 cases and 32 cases were respectively in the scar stage in the HP group and in the placebo group in 4 weeks after surgery， and there were 8 cases in the healing stage in the placebo group， but the difference was not statistically significant（P>0.05）. Conclusion The anti-Helicobacter pylori treatment can effectively help the healing of wound after the EMR surgery and obviously improve the healing rate of lesions.
[Key words] EMR； Ulcer after mucosectomy； Helicobacter pylori （Hp）
?染迪挛刚衬で谐?术目前已成为消化内镜技术下一个常用的治疗手段。胃粘膜切除术可以将胃内息肉在2.5 cm以内者整块切除。但胃息肉切除后创面如果不及时愈合很有可能出现出血穿孔等并发症。如果能帮助创面快速愈合就能减少这些并发症的出现。该文旨在研究抗幽门螺杆菌治疗是否能促进胃黏膜切除以后创面的愈合。因此，采取了胃息肉患者术前检测幽门螺旋杆菌的办法，将有幽门螺旋杆菌感染合并胃息肉需进行内镜下胃粘膜切除术者进行研究，判断2015年6月―2017年5月该院80例合并幽门螺杆菌感染患者行EMR术后根除HP对创面愈合情况的影响。以帮助日后临床治疗用药，现报道如下。
1 资料与方法
1.1 一般资料
方便选取该院收治的胃息肉性病变合并有幽门螺旋杆菌感染需行内镜下粘膜切除术患者。纳入标准：①年龄25～65岁；②病理为增生性息肉（炎性息肉）或腺瘤样息肉者；③术前经C14呼气试验明确为HP感染者；④在该研究之前未行抗HP治疗者。排除标准：①合并其他消化系疾病如胃食管术、胃溃疡、十二指肠溃疡影响观察疗效者；②病理为中重度不典型增生或癌变者；③无HP感染者；④已经行过抗HP治疗者；⑤伴有其他脏器功能不全系统疾病需同时服用其他药物影响观察者；⑥对该次研究所用药物过敏者；⑦术后病理提示为高级别上皮内瘤变或癌变者；⑧术后失访者。EMR术后溃疡分期采用的是日本畸田隆夫的分期法：活动期（A1、A2期）愈合期（H1、H2期）和疤痕期（S1、S2期）。
发表于 2018-8-14 22:57:57