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目的:通过对残胃粘膜幽门螺杆菌(Hp)感染情况的检测分析,探讨残胃病变与Hp感染的关系。方法:回顾分析1990 -2003年间3 479例残胃患者(残胃组)和3 400例同期患者(对照组)的胃镜及病理检查、Hp检测情况,对两组Hp感染率进行比较,同时对残胃组的不同年龄、性别、术后随访时间、手术方式、有否胆汁返流及各种残胃病变的Hp感染情况进行比较分析。结果:(1)残胃组Hp感染率为26.56%,明显低于对照组58.26%(P<0.01)。(2)残胃患者年龄越大.Hp感染率越低(P <0.01),而不同性别Hp感染率无显著差异(P>0.05)。(3)术后胃镜随访时间<6个月、6个月-5年、6-10年、11-20年、>20年,残胃患者Hp感染率分别为40.74%、32.93%、26.22%、10.89%、1.85%,各时间段比较,有显著差异(P<0.01) (4)Billroth Ⅰ式Hp感染率(37.62%)高于BillrothⅡ式和Roux-en-Y胃肠重建术式Hp感染率(19.12%、29.24%),3种术式比较,有显著差异(P<0.01)。(5)残胃炎、残胃溃疡、残胃癌变的Hp感染率分别为22.58%、61.12%、65.03%,前者与后两者比较,有显著差异(P<0.01)。(6)残胃伴及不伴胆汁返流者Hp感染率分别为7.49%、31.59%,两者差异显著(P<0.01)。结论:残胃患者Hp感染率低,且与年龄、手术术式、术后生存时间等相关,而与性别无关。残胃患者应定期行胃镜及病理检查?
Objective: To investigate the relationship between residual gastric lesions and Hp infection by detecting and analyzing the gastric mucosa Helicobacter pylori (Hp) infection. Methods: Gastroscopy and pathological examination of 3 479 patients with gastric remnant (gastric remnant group) and 3 400 patients (control group) from 1990 to 2003 were retrospectively analyzed. Hp infection rate was compared between the two groups, The age, gender, postoperative follow-up time, operation mode, whether there was bile reflux and various residual stomach lesions of Hp infection in the gastric group were compared. Results: (1) Hp infection rate in gastric residual group was 26.56%, which was significantly lower than that in control group (58.26%, P <0.01). (2) The older the residual gastric cancer patients, the lower the infection rate of H.pylori (P <0.01), but no significant difference in the infection rate of Hp between different sexes (P> 0.05). (3) Postoperative gastroscope follow-up time was 6 months, 6 months-5 years, 6-10 years, 11-20 years and> 20 years. The incidence of Hp infection in gastric residual patients was 40.74%, 32.93% and 26.22% (P <0.01). (4) The infection rate of Billroth Ⅰ Hp (37.62%) was higher than that of Billroth Ⅱ and Roux-en-Y gastrointestinal reconstruction of Hp infection Rate (19.12%, 29.24%), three kinds of surgical comparison, there are significant differences (P <0.01). (5) Hp infection rates of residual gastritis, residual gastric ulcer and gastric residual gastric cancer were 22.58%, 61.12% and 65.03%, respectively. There was significant difference between the former and the latter (P <0.01). (6) The infection rate of Hp in patients with gastric residual and without biliary reflux was 7.49% and 31.59%, respectively (P <0.01). Conclusion: The incidence of Hp infection in patients with gastric residual disease is low, and related to age, surgical procedures, survival time after surgery, etc., and has nothing to do with gender. Stomach patients should be regularly endoscopy and pathological examination?