幽门螺杆菌阴性消化性溃疡与出血关系的研究

目的探讨幽门螺杆菌(H.pylori)阴性消化性溃疡与出血之间的关系及其临床特点。方法选择急诊内镜诊断为胃溃疡和/或十二指肠溃疡患者160例,按照是否合并出血分为出血组和不伴出血组,各80例,并分析影响H.pylori阴性消化性溃疡合并出血的因素。结果出血组H.pylori阴性率为40%,不伴出血组H.pylori阴性率为14%,2组比较有显著性差异(P<0.05)。H.pylori阴性消化性溃疡合并出血与复合性溃疡、黏膜炎症和炎症程度存在明显的相关性,与十二指肠溃疡、胃溃疡、溃疡直径、溃疡分期、黏膜萎缩、肠化生和淋巴组织增生无明显相关性。结论 H.pylori阴性消化性溃疡在消化性溃疡出血中所占的比例较高,有复合性溃疡、黏膜炎症和炎症严重的患者可能更易并发消化道出血,需要引起消化专科医生的重视。

Study of relationship between Helicobacter pylori negative peptic ulcer and bleeding

Objective It is to investigate the relationship and it’s clinical features between Helicobacter pylori(Hp) negative peptic ulcer and bleeding.Methods 160 cases with gastric ulcer and(or) duodenal ulcer were analyzed by emergency endoscopic,according to the bleeding all were divided into two groups: bleeding group and no bleeding group,each group were 80 cases,and the impact of Hp-negative peptic ulcer were analyzed according to the bleeding.Results The Hp-negative rate of bleeding group was 40%,while 14% in no bleeding group,the difference was statistically significant(P<0.05) between the two groups.There were significant correlations among compound ulcer,inflammation of mucous,inflammation grade and bleeding of Hp-negative peptic ulcer(P<0.05),while there was no significant correlations among duodenal ulcer,gastric ulcer,the average diameter,ulcer stage,atrophy,intestinal metaplasia,lymphoproliferative and bleeding of Hp-negative peptic ulcer(P>0.05).Conclusion The proportion of ulcer bleeding in Hp-negative peptic ulcer is higher,patients with complex ulcer,mucosal inflammation,and severe inflammation may be more easily complicated with gastrointestinal bleeding,it need to be attracted attention by digestive specialists.