依据药物敏感试验根除幽门螺杆菌的临床疗效随访

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目的:在幽门螺杆菌(Helicobacter pylori,H.pylori)感染的患者中,根据药物敏感试验选择治疗方案与常规一线治疗方案进行临床疗效优劣的随访.方法:在浙江省嘉兴市第一医院内镜室行胃镜检查的患者中,胃镜检查时取材标本2块,分别送检常规组织病理学检查及组织切片染色检测及H.pylori的分离、培养、鉴定:其中H.pylori培养结果阳性的纳入治疗组,仅组织切片染色检测H.pylori阳性纳入对照组.治疗组根据药敏试验结果治疗10 d,对照组根据标准一线治疗方案治疗10d.治疗结束4 wk后的患者进行复查,任选一种复查方式(H.pylori培养或组织切片染色或14C呼气试验),三项之一阴性者可判断H.pylori根除.结果:H.pylori培养结果阳性的纳入治疗组(n=4680),仅组织切片染色检测H.pylori阳性纳入对照组(n=3505).治疗组根据药敏试验结果选用2种敏感度最高值抗生素参与的四联疗法治疗,对照组选用常规四联疗法,治疗结束4 wk后复查评估根除率.最终,治疗组的根除率为91.18%,比对照组根除率73.07%高,且差异有统计学意义(P<0.05).结论:依据H.pylori的药物敏感试验选择的治疗方案明显优于标准一线治疗方案. OBJECTIVE: To follow up the clinical curative effect of Helicobacter pylori (H.pylori) infection patients according to the drug sensitivity test and the first-line treatment plan.Methods: In the first hospital of Jiaxing City, Zhejiang Province In the endoscopic examination of the patients, gastroscopy specimens were taken 2, were submitted to routine histopathological examination and tissue section staining and H.pylori isolation, culture, identification: which H.pylori culture results were positive In the treatment group, H.pylori positive staining was detected only in the control group, the treatment group was treated for 10 days according to the susceptibility test results, the control group was treated for 10 days according to the standard first-line treatment plan, and the patients after 4 weeks of treatment were reviewed (H.pylori culture or tissue section staining or 14C breath test), one of three negative can be judged H.pylori eradication.Results: H.pylori culture positive results were included in the treatment group (n = 4680) Only histological sections were stained for H.pylori positive control group (n = 3505) .According to the results of susceptibility test, the treatment group was treated with quadruple therapy with the highest sensitivity of antibiotics, Quadruple therapy, 4 wk after the end of treatment review review eradication rate.Finally, the eradication rate of the treatment group was 91.18%, 73.07% higher than the control group, and the difference was statistically significant (P <0.05) .Conclusion: According to H The drug regimen chosen for the treatment of pylori is significantly better than standard first-line regimens.
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