本文選題：消化內(nèi)科 + 住院患者��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]自Marshall和Warren發(fā)現(xiàn)幽門螺桿菌(Helicoibacter pylori,HP)以來,人們對(duì)HP的研究愈來愈多,對(duì)其認(rèn)識(shí)也越來越深入。但目前針對(duì)消化內(nèi)科住院患者HP現(xiàn)癥感染的研究報(bào)道相對(duì)較少,可能造成許多HP現(xiàn)癥感染的病人常被臨床醫(yī)師忽略,導(dǎo)致HP的耐藥性愈來愈強(qiáng),根除治療越來越難。同時(shí),HP現(xiàn)癥感染目前與消化系統(tǒng)很多疾病存在相關(guān)性,不僅是胃腸及胃腸外疾病,甚至消化系統(tǒng)外疾病也有一定的聯(lián)系。為了更好地防治HP感染引起的相關(guān)性疾病,本研究針對(duì)上述問題,對(duì)成都軍區(qū)昆明總醫(yī)院消化內(nèi)科住院患者進(jìn)行了研究,旨在調(diào)查消化內(nèi)科住院患者HP現(xiàn)癥感染情況并分析相關(guān)因素,進(jìn)而提出預(yù)防措施,更好地干預(yù)HP感染相關(guān)疾病。[方法]選取2011年10月～2015年5月在我院消化內(nèi)科住院的患者共3684例,應(yīng)用13C-尿素呼氣試驗(yàn)(13C-Urea Breath Test)檢測幽門螺桿菌現(xiàn)癥感染情況,以年齡、性別和病種進(jìn)行分組,分析不同狀況下幽門螺桿菌的感染情況。[結(jié)果]1.對(duì)2011年10月～2015年5月間的3684例消化內(nèi)科住院患者進(jìn)行13C-尿素呼氣試驗(yàn)檢測,HP總的現(xiàn)癥感染率為23.0%(848/3684),其中男性為23.5%,女性為22.4%,兩組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2.從年齡分布來看,中年組的HP現(xiàn)癥感染率(26.3%,322/1223)顯著高于青年組(19.4%,160/664)(P0.01)和老年組(23.1%,378/1259)(P0.05),老年組也顯著高于青年組(P0.05);呈現(xiàn)出隨著年齡的增長,其感染率逐漸增高后又逐漸降低,在中年組中達(dá)到高峰。3.從性別分布來看,中年組中男性組及女性組HP現(xiàn)癥感染率分別為28.7%(187/650)及23.6%(135/573),中年男性組HP現(xiàn)癥感染率顯著高于中年女性組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。而青年組、老年組男性與女性HP現(xiàn)癥感染率相比差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。4.從消化系統(tǒng)不同器官疾病間HP現(xiàn)癥感染分布情況來看,上消化道疾病、下消化道疾病、肝膽疾病、胰腺疾病、腹腔疾病HP現(xiàn)癥感染率分別為25.5%(646/2529)、20.3%(64/315)、19.0%(128/672)、10.4%(7/67)、3.0%(3/101),五組疾病HP現(xiàn)癥感染率比較差異有統(tǒng)計(jì)學(xué)意義(P0.01),其中以上消化道疾病患者最高(P0.05)。5.從消化系統(tǒng)常見疾病間HP現(xiàn)癥感染分布情況來看,HP現(xiàn)癥感染率最高的5種疾病分別是消化性潰瘍36.7%(166/452)、胃惡性腫瘤30.6%(19/32)、慢性胃炎26.1%(354/1354)、結(jié)腸惡性腫瘤25.9%(14/54)、結(jié)腸息肉25%(30/120),而胃食管返流病14.5%(20/138)最低。[結(jié)論]1.消化內(nèi)科住院患者HP現(xiàn)癥感染率較高,尤其在中年組中更高。呈現(xiàn)出隨著年齡的增長,其感染率逐漸增高后又逐漸降低,在中年組中達(dá)到高峰。2.從不同年齡組的性別來看,中年組男性HP現(xiàn)癥感染率顯著高于女性組。3.上消化道疾病HP現(xiàn)癥感染明顯高于下消化道疾病。在下消化道疾病中,結(jié)腸惡性腫瘤、結(jié)腸息肉HP感染率也在不斷增加,可能HP感染增加了結(jié)直腸腫瘤及結(jié)直腸息肉的發(fā)生風(fēng)險(xiǎn),值得進(jìn)一步關(guān)注。4.肝膽疾病、胰腺疾病等胃腸外疾病HP現(xiàn)癥感染率較高,HP感染可能是肝膽、胰腺疾病的重要誘因之一,值得進(jìn)一步關(guān)注。5.不同病種間的HP現(xiàn)癥感染率不同,HP仍是消化性潰瘍、慢性胃炎、胃惡性腫瘤的主要致病菌,而HP對(duì)胃食管反流病可能有保護(hù)作用。6.不同病種間的HP現(xiàn)癥感染率不同,各有其不同的臨床意義。
[Abstract]:[Objective] since the discovery of Helicoibacter pylori (HP) by Marshall and Warren, there are more and more researches on HP, and the understanding of it is becoming more and more in-depth. But at present, there are relatively few reports on the infection of HP present in the inpatients of digestive medicine, which may cause the patients with the present disease of Xu to be neglected by the clinicians and lead to H. The drug resistance of P is becoming stronger and stronger, and the eradication therapy is becoming more and more difficult. At the same time, the present infection of HP is associated with many digestive diseases, not only the gastrointestinal and gastrointestinal diseases, but also the digestive diseases. In order to better prevent and cure the related diseases caused by HP infection, this study is aimed at the above problems in the Chengdu army. The hospitalized patients in the digestive department of Kunming General Hospital of Kunming were studied. The purpose of this study was to investigate the current infection of the patients in the digestive department and analyze the related factors, and then put forward the preventive measures to better interfere with the HP infection related diseases. [Methods] 3684 patients hospitalized in the medicine department of our hospital from October 2011 to May 2015 were selected and 13C- urine was applied. 13C-Urea Breath Test (Test) was used to detect the present infection of Helicobacter pylori. The infection of Helicobacter pylori in different conditions was analyzed in groups with age, sex and disease. [results]1. test of 13C- urea breath test for 3684 hospitalized patients with digestive medicine from October 2011 to May 2015 and the present infection of HP The rate was 23% (848/3684), among which men were 23.5%, women were 22.4%, and there was no statistically significant difference between the two groups (P0.05).2. from the age distribution, the prevalence rate of HP in the middle age group (26.3%, 322/1223) was significantly higher than that in the young group (19.4%, 160/664) (P0.01) and the elderly group (23.1%, 378/1259) (P0.05), and the elderly group was also significantly higher than the young group (P0.05). With the increase of age, the infection rate gradually increased and decreased gradually. In the middle age group, the peak.3. from the middle age group was 28.7% (187/650) and 23.6% (135/573) in the middle age group and the female group, respectively. The prevalence rate of HP in middle age group was significantly higher than that in the middle age group, and the difference was statistically significant (the difference was statistically significant). P0.05). Compared with the young group, there was no significant difference in the prevalence of HP infection among the old men and women (P0.05). The infection rate of upper digestive tract disease, lower digestive tract disease, hepatobiliary disease, pancreatic disease, and abdominal disease HP was 25.5% (646/2529), 20.3% (646/2529), respectively, compared with the distribution of HP infection in different organs of the digestive system. (64/315), 19% (128/672), 10.4% (7/67), 3% (3/101), five groups of disease HP infection rates were significantly different (P0.01), of which the highest (P0.05).5. from the digestive system common disease among the common disease distribution of HP, the highest rate of HP infection rate of the 5 diseases were 36.7% of peptic ulcers (166/45, 36.7%) 2) gastric malignant tumor 30.6% (19/32), chronic gastritis 26.1% (354/1354), colon malignant tumor 25.9% (14/54), colon polyp 25% (30/120), and gastroesophageal reflux disease 14.5% (20/138) lowest. [conclusion]1. digestive internal medicine inpatients with higher HP present infection rate, especially in middle age group. With age increase, the infection rate gradually increases. In the middle age group, the peak value of.2. was higher than that in the different age groups. The prevalence rate of HP in the middle age group was significantly higher than that of the female group.3.. The infection rate of HP in the upper gastrointestinal tract was significantly higher than that of the lower digestive tract disease. In the lower digestive tract diseases, the colon malignant tumor, the HP infection rate of colon polyps were also increasing, and the possible HP infection was possible. To increase the risk of colorectal cancer and colorectal polyps, it is worth further attention to.4. liver and gallbladder disease, pancreatic disease and other gastrointestinal diseases, HP infection rate is high, HP infection may be one of the important causes of liver and gallbladder, pancreatic disease, it is worth further attention to the different diseases among different diseases of.5. infection rate of HP is different, HP is still peptic ulcer, Chronic gastritis, the main pathogenic bacteria of gastric malignant tumor, and HP may have protective effect on gastroesophageal reflux disease. The infection rate of HP between different diseases of.6. is different, each has its different clinical significance.

【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R573

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