根除幽门螺杆菌和内镜下气囊扩张治疗幽门梗阻的远期疗效

目的:前瞻性追踪观察经内镜气囊扩张和根除幽门螺杆菌(Hp)对十二指肠球部溃疡(DU)所致幽门梗阻的远斯疗效。方法:对25例DU合并幽门梗阻者给予气囊扩张和四联方案根除Hp治疗,且随访在12月以上者进入统计分析。Hp感染用尿素酶、组织学和全血抗体测定。Hp是否根除用~(14)C尿素呼气试验。结果:25例均成功经内镜气囊扩张而无并发症。最后气囊直径:11例12mm,10例15mm,4例18mm。21例(84.0％)行根除Hp治疗均成功根除Hp,4例Hp阴性者而未行根除治疗。平均随访34月。Hp根除者梗阻复发率4.7％(1/21),显著低于未行根除治疗的复发率50.0％(2/4)(P<0.05)。结论:气囊扩张和根除Hp治疗DU导致的幽门梗阻可获得较好的远期效果。

Long-term Outcome of Endoscopic Balloon Dilation and Helicobacter Pylori Eradication for Benign Pyloric Stenosis.

Puipose; To determine the long-term outcomes of endoscopic balloon dilation and helicobacter pylori(Hp) eradication for duodenal ulcer induced pylori stenosis. Methods: 25 patients undenvent through - the - scope balloon dilation for pyloric stenosis,and Hp infection was determined using the rapid urease test, histology and serology.The patients with one positive of three Hp tests then received quadruple therapy (omeprazole, bismuth, amox-illine, and metronidazole) after dilation. Hp eradication was determined using 14C urea breath test. Results: All 25 patients undenvent successful dilation, of which dilation to at least 12 mm was in 31 patients, 15 mm in 10 patients, and 18 mm in 4 patients. Four individuals required more than one session, and 21 patients had a single procedure, with symptoms immediate relief. At the median follow-up of 34 months,20 of 21 patients with successful eradicated Hp remained asymptomatic, while other 2 of 4 patients with Hp negative and without eradication had a recurrent obstiuction and required subsequent surgery. Conclusion: The endoscopic balloon dilation is safe and effective, and Hp eradication improves the long-term efficacy for the treatment of duodenal ulcer induced pyloric stenosis.