【摘要】 目的　探讨胃大部切除术后残胃病变与Hp感染的关系。方法　采用快速尿素酶试验、PCR法、组织切片Warthin starry银染及血清ELISA法检测重庆地区 136例残胃病患者Hp感染情况 ,并进行流行病学分析。结果　 136例残胃病患者Hp感染检出率为 43.4% ,与年龄、性别以及术后时间无关 ;毕I式术后残胃Hp检出率 ( 6 5 .8% )明显高于毕II式术后残胃Hp检出率 ( 34.0 % ) ,而伴有胆汁返流的残胃Hp感染阳性率 ( 2 3.1% )明显低于不伴胆汁返流的残胃阳性率 ( 5 6 .0 % )。同时 ,因溃疡、穿孔、出血行手术的残胃Hp检出率 ( 4 7.7% )高于因胃癌手术的检出率 ( 2 4.2 % ) ;不同病理学残胃中 ,残胃溃疡和残胃癌的Hp感染率明显高于慢性残胃炎及吻合口炎Hp感染率。结论　胃大部切除术后残胃病变与Hp感染密切相关 ,尤其是残胃癌 ,应及早进行Hp治疗 ,可减轻残胃病变 ,减少残胃癌的发生更多还原

【Abstract】 Objective To investigate the relationship between gastric remnant after subtotal gastrectomy and infection of Helicobacter pylori (Hp). Methods A total of 136 patients with remnant stomach in Chongqing were subjected to gastroendoscopy and biopsy specimens were taken. Rapid urease test, PCR, histological study with Warthin Starry staining and ELISA were used to detect Hp infection. Data were analyzed for epidemiology . Results Hp infection was detected in 43.4% patients with remnant stomach. No correlation was found between the Hp infection and the patients’ age, sex and post operative duration. The infective rate of Hp was significantly higher in those with B Ⅰ reconstruction (65.8%) than those with B Ⅱ (38.1%), and in those without bile reflux (56.0%)than those with (23.1%). Significant higher infection was also seen in those operated due to peptic ulcer, stomach perforation and gastrorrhagia (47.7%) than those due to gastric cancer (24.2%), and those with ulcer and cancer in remnant stomach than those with chronic gastritis of the remnant stomach and infection of the anastomotic inflammation. Conclusion The lesion of gastric remnant was closely associated with Hp infection, especially in gastric residual cancer. Early treatment was recommended in Hp infection to reduce gastric residual lesion and decrease carcinogenesis in gastric remnant.更多还原