【摘要】 目的　通过检测残胃粘膜幽门螺杆菌 (HP)感染 ,探讨HP与残胃病变的关系。方法　对 2 5 8例胃大部分切除术后残胃病变患者的胃镜、病理及Hp检测结果进行分析 ,并与同期 2 5 8例非残胃病变为对照组的Hp感染率进行对照分析。结果　残胃组Hp阳性检出率 (37.6 % )显著低于对照组 (6 9.8% ) (P <0 .0 1)。BillrothⅠ氏术后残胃和BillrothⅡ氏术后残胃Hp的感染率分别为 5 2 .8%和 2 1.3% ,两者比较差异显著 (P <0 .0 1)。BillrothⅡ氏术后伴胆汁返流者明显高于BillrothⅠ氏术后 (P <0 .0 1)。胆汁返流组中Hp的感染率 2 2 %显著低于无胆汁返流组的 6 4 .5 % (P <0 .0 1)。残胃并发症中 ,残胃及吻合口炎和残胃及吻合口溃疡的Hp感染率分别明显低于对照组中的慢性胃炎和消化性溃疡的Hp感染率 (P <0 .0 1) ,但残胃及吻合口炎的Hp感染率为 4 6 .1% ,高于残胃及吻合口溃疡的 2 1.6 %。另外 ,残胃及残胃复发癌的Hp感染率和残胃及吻合口炎中异型增生的Hp感染率与对照组相比 ,差异无显著性 (P >0 .0 5 )。结论　Hp感染是导致残胃病变发生的病因之一。胆汁返流在残胃病变的发生中起主要作用 ,但在残胃及吻合口炎和残胃复发癌中 ,Hp感染也可能占了较重要的地位 ,Hp感染是BillrothⅠ氏术后残胃病变的主要病因。根治Hp有重要?更多还原

【Abstract】 Objective To appsoach the relationship between Hp and remnant stomach complications of post-gastrectomy by examining Hp infction in the mucous membrane of the remnant stomach. Methods The results of the gasteoscopic, pathological and Hp examination of 258 cases with remnant stomach (Group 1) were analyzed and compared to the control group (Group 2).Results The posifive reaction rate of Hp in Group 1 (37.6%) was obviously lower than that in Group 2 (69.8%) ( P <0.01). The infection rates of the remnant stomach after Billroth Ⅰand Billroth Ⅱ were respeotively 52.8% and 21.3%, there was a marked difference between them ( P <0.01). Cases with Bile reflux after Billroth Ⅱwere noticeablely more than that after Billroth Ⅰ( P <0.01), and the Hp infection rate of cases with bile reflux (22%) was strikingly lower than those without Bile reflux (64.5%) ( P <0.01).In the remnant stomach complication of post-gastrectomy, the Hp infection rates of cases with remnant stomach and anastomotic inflammation and ulcer were evidently lower than those of cases with chronical gastritis and digestive ulcer ( P <0.01), but the Hp infection rates of cases with remnant stomach and anastomotic inflammation were 46.1%, much higher than those of cases with remnant stomach and anastomotic ulcer (21.6%)( P <0.01=). Moreover, there was little difference between Group 1 and Group 2 as far as Hp infection rates of remnant stomach cancer and recurrent cancer and the non-typical hyperplasia of cases with remnant stomach and anastomotic inflammation were concerned ( P >0.05=).Conclusions Hp infection is one of the causes of remnant stomach complications, But Bile reflux is mainly responsible for them. However, as far as cases with remnant stomach and anastomotic inflammation and remnant stomach recurrent cancer are concerned, Hp infection may be one of the main cause, and it is also responsible for remnant stomach complications after Billroth Ⅰ. Therefore, it is very important to effect a radical cure of Hp.更多还原