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目的对比三联与四联疗法治疗内镜黏膜下剥离术(ESD)后幽门螺杆菌(Hp)感染的效果。方法选取ESD术后1周Hp感染患者82例,随机分为对照组(40例)和观察组(42例)。对照组给予埃索美拉唑+阿莫西林+呋喃唑酮治疗,观察组在对照组基础上,加用胶体果胶铋胶囊治疗,治疗4 w后,比较两组Hp根治率、溃疡愈合率、溃疡愈合质量以及两组治疗前后胃溃疡黏膜或瘢痕组织胶原纤维含量、中性黏液含量、白介素6(IL-6)、IL-10水平。结果观察组Hp根治率、溃疡愈合率、溃疡愈合质量为优的比例分别为92.86%、83.33%、64.29%,均显著高于对照组的75.0%、60.0%、40.0%(P<0.05);治疗后,观察组粘膜肉芽组织胶原纤维、中性黏液含量、IL-10水平高于对照组,IL-6水平低于对照组(P<0.05)。结论四联疗法治疗ESD术后Hp感染,可减少炎性浸润,提高创面愈合质量,疗效更好。
Objective To compare the efficacy of triple and quadruple therapy in the treatment of Helicobacter pylori (Hp) infection after endoscopic submucosal dissection (ESD). Methods 82 patients with Hp infection one week after ESD were randomly divided into control group (40 cases) and observation group (42 cases). The control group was treated with esomeprazole + amoxicillin + furazolidone. The observation group was treated with colloidal bismuth pectin capsules on the basis of the control group. After 4 weeks of treatment, the cure rates of Hp, ulcer healing, ulcer The quality of healing and the contents of collagen fibers, neutral mucus, interleukin 6 (IL-6) and IL-10 in mucosa or scar tissue of gastric ulcer before and after treatment. Results The rates of radical cure rate, ulcer healing and ulcer healing were 92.86%, 83.33% and 64.29% in the observation group, which were significantly higher than those in the control group (75.0%, 60.0% and 40.0%, P <0.05). After treatment, the mucosal granulation tissue collagen fibers, the neutral mucus content and IL-10 level in the observation group were higher than those in the control group, while the levels of IL-6 in the observation group were lower than those in the control group (P <0.05). Conclusions Four-combined therapy for Hp infection after ESD can reduce the inflammatory infiltration, improve the quality of wound healing, and have better curative effect.