小儿胃镜检查在HP相关性胃炎的临床应用　_临床医学论文.docVIP

小儿胃镜检查在HP相关性胃炎的临床应用　_临床医学论文 小儿胃镜检查在HP相关性胃炎的临床应用　_临床医学论文 【摘要】 目的评价小儿胃镜检查在幽门螺杆菌（Helicobacter.py lori，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果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）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（χ 2 分别=70.91、71.54，P均lt;0.05）。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=125、7.00，P均lt;0.05）。结论小儿胃镜检查是小儿HP相关性胃炎的重要诊断手段之一。 【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】Objective To evaluate clinical application of gastroscopy for children with helicobacter pylori-related gastritis.Methods 132children with gastritis were assigned into3groups:group A（children with Hp-related gas-tritis）;group B（children with Hp negative gastritis）;group C（children uncooperative to gastroscopy）.Each group re-ceived the same basic treatment，besides group A received normal triple therapy for anti-Hp.In each group，gas-troscopy results and mucosal histopathological changes before and4weeks，6～12months after treatmentwere observed.Results Four weeks after treatment，the effective rates of abdominal pain and epigastrium tenderness in oroup A were92.16%（47/51）and94.12%（48/51）;in group B，they were88.89%（8/9）and88.89%（8/9）;in group C，they were16.17%（11/66）and13.64%（9/66）.Group A had significant differences with group B and group C（χ 2 =70.91，71.54，0.05）.The follow-up of6～12months indicated that47cases（47/51）were with successive negative-Hp in group A，inflammation was controlled，inflammation degree and activity were less than those before treatment;the inflammation degree in group B after therapy was less than those before treatment（u=125，7.00，0.05）.Conclusion Gastroscopy is an important means to diagnose helicobacter pylori-related gastritis in children. 【Key words】gastroscopy for children;recurrent abdominal pain;helicobacter pylori-related gastritis 小儿胃炎的临床诊断标准模糊，这是因为过去在诊断胃炎时对其病因