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目的：评价由雷贝拉唑、果胶铋、阿莫西林克拉维酸钾、左氧氟沙星、奥硝唑组成的10 d序贯疗法与10 d标准四联疗法对幽门螺杆菌（Hp）初治失败患者补救治疗的疗效及安全性。方法选取2012年4月至2014年2月永州市中心医院收治的Hp初次根除失败患者136例，随机均分为治疗组和对照组。治疗组前5 d予雷贝拉唑20 mg、果胶铋300 mg、阿莫西林克拉维酸钾1142.5 mg，口服2次/d，后5 d予雷贝拉唑20 mg、果胶铋300 mg、左氧氟沙星200 mg、奥硝唑500 mg，口服2次/d。对照组予雷贝拉唑20 mg、果胶铋300 mg、阿莫西林克拉维酸钾1142.5 mg、奥硝唑500 mg，口服2次/d，疗程10 d。观察药物不良反应发生率，停药治疗4周后行14 C呼气试验测定Hp。结果治疗组ITT根除率（91.18%）、PP根除率（93.94%）均较对照组（分别为79.41%和83.08%）高，差异有统计学意义（P0.05）。结论由雷贝拉唑、果胶铋、阿莫西林克拉维酸钾、左氧氟沙星、奥硝唑组成的10 d序贯疗法是一种Hp初治失败后安全而有效的补救治疗方案。“,”Objective To evaluate the curative effect and security between 10-day sequential therapy including rabeprazole, colloidal Bismuth Pectin, amoxicillin and clavulanate potassium, levofloxacin and ornidazole and 10-day standard quadruple therapy for patients who fail on first-line Helicobacter pylori( H.pylori) eradication. Methods 136 Hp-positive patients with treatment failure of initial eradication were randomly divided into treatment group which included 68 patients and control group which included 68 patients.The treatment group was treated with rabeprazole 20 mg,colloidal Bismuth Pectin 300mg and amoxicillin and clavulanate potassium 1142.5 mg at first five days,orally two times a day at first five days and rabeprazole 20 mg,colloidal Bismuth Pectin 300 mg,levofloxacin 200 mg,and ornidazole 500 mg, orally two times a day at the second five days. The control group was treated with rabeprazole 20 mg, colloidal Bismuth Pectin 300 mg,amoxicillin and clavulanate potassium 1142.5mg and ornidazole 500mg, orally two times a day for ten days. The incidence of drug-related adverse reaction was observed during the medication and H.pylori was detected by 14C-urea breath test 4 weeks after discontinuation. Results The intention-to-treat eradication rate and Per protocol eradication rate in treatment group were higher than that in control group(91.18%, 93.94%vs 79.41%,83.08%),and the difference between two groups was statistically significant(P0.05). Conclusion The 10-day sequential therapy including rabeprazole, colloidal Bismuth Pectin, amoxicillin and clavulanate potassium, levofloxacin and ornidazole is an very safe and effective rescue therapy for Helicobacter pylori infection after initial treatment failure.