胃大部切除术式与幽门螺杆菌感染相关性的研究

目的 观察Billroth Ⅰ式和Billroth Ⅱ式术后、胆汁反流与残胃幽门螺杆菌（HP）感染之间的关系。方法残胃组患者101例，其中Billroth Ⅰ式58例，Billroth Ⅱ式43例，同期未手术患者4501例作为对照组。残胃组内又分别根据HP、胆汁反流与否、反流程度分层比较。以快速尿素酶试验法及改良Giemsa染色检测HP。结果残胃组HP感染率（21．79％）显著低于对照组（41．16％），两组之间比较具有统计学意义（P〈0．05）；Billroth Ⅰ式组HP感染率为21．43％、Billmth Ⅱ式组HP感染率为22．22％，两组比较无统计学意义；Billroth Ⅰ式组胆汁反流阳性率57．14％与Billmth Ⅱ式组的88．89％相比较具有统计学意义（P〈0．001）；残胃胆汁反流阳性患者HP感染率为35．44％、胆汁反流阴性患者HP感染率为45．45％，两组比较具有统计学意义（P〈0．01）；残胃组患者不同程度胆汁反流的HP感染率之间无统计学意义；不同程度胆汁反流的HP现患比均〈1．0。结论残胃HP感染率低于未手术者，胆汁反流是HP感染的保护因素，但与HP感染严重程度无线性关系。

Correlation clinical study about partial gastric resection and Helicobacter pylori infection

Objective To investigate the relationship among operation of BillroⅠ , BillrothI , bile reflux and Helicobacter pylori（H, pylori） infection. Methods We investigated 101 patients with remnant stomach as remnant stomach groups including the BillrothⅠ greup（B - Ⅰ, n = 58） and the Billreth Ⅱ group （B- Ⅱ, n =43） and 4501 nonresected patients as control groups at the same time. In the remnant stomach groups, we divided into some groups respectively according to H. pylori, bile reflux again. H. pylori status was diagnosed by rapid urease test and histological examination. Results There was significant difference （p 〈 0.05） between the prevalence of H. pylori infection in the remnant stomach groups（21.79% ） with the control groups （41.16%） ; There was not significance of difference between the prevalence of H. pylori infection in the B - Ⅰ group（21.43% ） with the B -Ⅱ group（22. 22 % ） ; The positive bile reflux in the B - Ⅰ group （57.14 % ） was significantly lower than the B -Ⅱ group （ 88.89 % ） （ p 〈 0. 001 ） ; We found there were statistical significance（p 〈0.01） of the prevalence of H. pylori infection between positive bile reflux patients（35.44%） with negative ones（45.45%）, but there was no statistical significance among different grade bile reflux groups; The prevalence ratios （PR） of different grade bile reflux groups were smaller than 1.0. Conclusions The prevalence of H. pylori infection in the gastric stump was lower than in the control group ; the bile reflux is the protective factors against H. pylori infection , and it is not correlated with the grade of H. pylori infection.