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1、临床医学论文•小儿胃镜检查在HP相关性胃炎的临床应用【摘要】目的评价小儿胃镜检查在幽门螺杆菌(Helicobacter.pylori,HP)相关性胃炎的临床应用价值。方法将临床初步考虑132例小儿胃炎患者，根据胃镜检查与否及结果分组，即A组(HP相关性胃炎组)、B组(HP阴性胃炎组、C组(未经胃镜检查组)，除A组给予正规三联抗HP治疗外，三组基础治疗相同，观察各组治疗前后4周症状、体征比较，6〜12个月随访胃镜检查结呆和黏膜组织病理学变化。结果治疗后4周腹痛及上腹压痛好转率A组分别是92.16%(47/51)、94.12%(48/51),B组分别是88.89%(8/9)、88.89%(8/9)
2、与C组16.67%(11/66)＞13.64%(9/66)。A组与B、C组比较，差异均有统计学意义(x2分别二70.91、71.54,P均＜0.05)o在6〜12个月随访发现A组HP持续阴性47例(47/51),炎症得到持续的控制，炎症程度和炎症活动度病例明显低于治疗前，B组经过对因治疗后炎症程度明显低于治疗前(u分别二125、7.00,P均＜0.05)o结论小儿胃镜检杳是小儿HP相关性胃炎的重要诊断手段Z-o【关键词】小儿胃镜儿童再发性腹痛幽门螺旋杆菌相关性胃炎【Abstract]ObjectiveToevaluateclinicalapplicationofgastroscopyforch
3、ildrenwithhelicobacterpylori-relatedgastritis・Methods132childrcnwithgastritiswereassignedinto3groups:groupA(childrenwithHp-relatedgas-tritis);groupB(childrenwithHpnegativegastritis);groupC(childrenuncooperativetogastroscopy).Eachgroupre-ceivedthesamebasictreatment,besidesgroupAreceivednormaltripleth
4、erapyforanti-Hp.Ineachgroup,gas-1roscopyresultsandmucosalhistopathologicalchangesbeforeand4weeks,6〜12monthsaftertreatmentwereobserved.ResultsFourweeksaftertreatment,theeffectiveratesofabdominalpainandepigastriumtendernessinoroupAwere92.16%(47/51)and94.12%(48/51);ingroupB,theywere88.89%(8/9)and88.89%
5、(8/9);ingroupC,theywerel6.17%(11/66)andl3.64%(9/66).GroupAhadsignificantdifferenceswithgroupBandgroupC(x2二70.91,71.54,P<0.05).Thefollow-upof6^12monthsindicatedthat47cases(47/51)werewithsuccessivenegative-HpingroupA,inflammationwascontrolled,inflammationdegreeandactivitywerelessthanthosebeforetreatme
6、nt;theinflammationdegreeingroupBaftertherapywaslessthanthosebeforetreatment(u二125,7.00,Pv0・05).ConclusionGastroscopyisanimportantmeanstodiagnosehelicobacterpylori・relatedgastritisinchildren.[Keywords!gastroscopyforchildren;recurrentabdominalpain;helicobacterpylori-relatedgastritis小儿胃炎的临床诊断标准模糊，这是因为过
7、去在诊断胃炎时对其病因不十分了解所造成的。口Marshan和Warren于1983年在胃炎患者中发现了幽门螺旋杆菌(HelicobacterPylori,HP),明确了HP感染是引起慢性胃炎的最常见病因[1]o而HP相关性胃炎的诊断有赖于胃镜检查(快速尿索酶试验测定+组织学检查)和非侵入性13C呼气试验，而后者在人部分医院缺少仪器，前者为侵入性检杳，使家长及儿童难以接受而造成诊治困难。下面分析胃镜
