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目的 比较不同方案治疗小儿消化性溃疡的疗效和幽门螺杆菌 (Hp)根除率 ,并随访 2年 ,以评价Hp在小儿消化性溃疡愈合和复发中的作用。方法 1 1 3例Hp感染伴消化性溃疡患儿分 4组接受治疗。A组奥美拉唑 0 8mg/(kg·d)顿服 ,疗程 2周 ;B组西咪替丁 1 5mg/(kg·d)或雷尼替丁 5mg/(kg·d) ,每日分 2次口服 ;C组胶体枸橼酸铋 8mg/(kg·d) ,每日分 3次口服 ;D组硫糖铝 2 5mg/(kg·d) ,每日分 4次口服。上述各组同时加服阿莫西林 50mg/(kg·d)和甲硝唑 1 5mg/(kg·d) ,均分 3次口服 ;B、C和D组疗程均 4周。 结果 ①溃疡治愈率 :A组 96% ( 46/4 8) ,B组 81 % ( 2 6/3 2 ) ,C组 85% ( 1 7/2 0 ) ,D组 69% ( 9/1 3 ) ;Hp根除率 :A组 85% ( 41 /4 8) ,B组 53 %( 1 7/3 2 ) ,C组 75% ( 1 5/2 0 ) ,D组 3 8% ( 5/1 3 )。②Hp根除者溃疡愈合率 1 0 0 % ,未根除者愈合率 57% ,差异有显著性 (P <0 0 1 )。③随访发现Hp未根除者溃疡复发率 60 % ,反之根除者仅 4 %。 结论 根除Hp可以提高小儿消化性溃疡愈合率 ,降低溃疡复发率。质子泵抑制剂奥美拉唑加二联抗生素治疗小儿Hp感染的消化性溃疡具有疗效高的特点。
Objective To compare the efficacy of different regimens in the treatment of pediatric peptic ulcer and the eradication rate of Helicobacter pylori (Hp) and follow up for 2 years to evaluate the role of Hp in the healing and recurrence of peptic ulcer in children. Methods A total of 113 children with Hp infection and peptic ulcer were divided into 4 groups. Group A omeprazole 0 8mg / (kg · d) Dayton clothing, treatment for 2 weeks; Group C cimetidine 15mg / (kg · d) or ranitidine 5mg / (kg · d), daily Divided into 2 times orally; Group C colloidal bismuth citrate 8mg / (kg · d), 3 times a day orally; group D sucralfate 25mg / (kg · d), 4 times a day orally. The above groups were given oral amoxicillin 50mg / (kg · d) and metronidazole 15mg / (kg · d), were divided into 3 oral; B, C and D treatment groups were 4 weeks. Results ① The cure rate of ulcer was 96% (46/48) in group A, 81% (26/3/2) in group B, 85% (1/7/2) in group C and 69% (9/1 3) in group D ); Hp eradication rate was 85% (41/48) in group A, 53% (17/3/2) in group B, 75% (15/2/2) in group C and 38% 3). ②Hp eradication ulcer healing rate was 100%, the rate of non-eradication was 57%, the difference was significant (P <0.01). ③ Follow-up found that Hp not eradication ulcer recurrence rate of 60%, while eradication only 4%. Conclusion Eradication of Hp can improve the healing rate of peptic ulcer in children and reduce the recurrence rate of ulcer. Proton pump inhibitor omeprazole plus two antibiotics in children with Hp infection of peptic ulcer with high efficacy characteristics.