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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。方法回顾性调查上海市华东医院1990年至2003年间3479例残胃患者(残胃组)和3400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、有否胆汁反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,差异有显著性(P<0.01)。④BillrothⅠ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,差异有显著性(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,差异有显著性(P<0.01)。⑥残胃伴及不伴胆汁反流者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?
Objective To investigate the relationship between residual gastric lesions and Hp infection by detecting and analyzing the infection of Helicobacter pylori (Hp) in gastric mucosa. Methods The gastroscopy and pathological examination, Hp detection of 3479 cases with gastric residual disease (gastric remnant group) and 3400 cases (control group) from Shanghai Huadong Hospital from 1990 to 2003 were retrospectively analyzed. The prevalence of Hp infection was compared between the two groups At the same time, we compared the Hp infection in different groups such as age, sex, postoperative follow-up time, operation method, bile reflux and various residual gastric lesions in the residual group. Results ① Infection group Hp infection rate was 26.56%, significantly lower than the control group 58.26% (P <0.01). ② The older the residual gastric cancer patients, the lower the infection rate of Hp (P <0.01), while the infection rate of Hp in different sex was not significantly different (P> 0.05). ③ Postoperative gastroscope follow-up time was 6 months, 6 months to 5 years, 6 to 10 years, 11 to 20 years, and> 20 years. The Hp infection rates in patients with gastric residual disease were 40.74%, 32.93%, 26.22% and 10.89 %, 1.85% respectively. There was significant difference between each time period (P <0.01). The infection rate of Billroth Ⅰ Hp (37.62%) was higher than that of Billroth Ⅱ and Roux-en-Y gastrointestinal reconstruction (19.12%, 29.24%). There was significant difference between the three kinds of operation (P0.01) . (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, time to survival and so on, and has nothing to do with gender. Stomach patients should be regularly scheduled?