序贯法治疗一线二线根治失败的幽门螺杆菌感染的疗效观察

目的：观察全国幽门螺杆菌（HP）科研协作组2006年5月制定的补救方案中的序贯疗法治疗一线、二线根治失败的HP感染的疗效。方法：行胃镜检查以胃黏膜快速尿素酶检测及病理染色检查方法确认为HP感染的患者。以国际标准一线或二线治疗方案进行根治，停药4周后^14C呼气试验仍为阳性的患者判定为根治失败。用2006年5月全国HP科研协作组制定的“HP补救治疗方案（草案）”C组序贯法再次治疗，本研究选择C1组和C3组方案，并以^13C呼气试验作为疗效判定。结果：62例一线或二线治疗Hp感染失败的患者，采用序贯法补救治疗后，50例根治成功，成功率为80．7％；按照C1组方案根治后24例HP根治成功。根除率77．4％（24／31）；按照C3组方案根治后26例HP根治成功，根除率83．9％（26／31）。不良反应发生率为12．9％，主要为恶心，症状轻微。结论：序贯疗法C1组及C3组方案对一线、二线根治失败的HP感染是一种安全、有效的治疗方案。两组方法疗效相似，均可作为一线、二线HP感染根治失败后补救治疗的选择方案。

The sequential therapy on a choice to treat helicobacter pylorl eradication failure

Objective ：To investigate the efficacy of the sequential therapy to eradicate helicohacter pylori after first-llne or secondline treatment failure. Methods：The patients with helicobacter pylori infection confirmed by rapid urease test and pathological examination receiving first-line or second-line international therapy were enrolled.The initial treatment failed if 14C breath test was positive 4 weeks later. Then such patients received the sequential thempy.14C breath test was used again to see whether the eradication of helicohacter pylori was finally achieved or not. Results：62 patients with initial treatment failure were included in our study and 50 patients achieved eradication of helicohacter pylori after the sequential therapy.The eradication rate was 80.7% and minor adverse affects including nausea happened in 12.9% of patients.Conclusion：The sequential therapy is an effective,safe choice after first-line or second-llne international treatment failure for helicohacter pylori infection.