Üçlü tedavi sonrası semptomları kaybolan ancak Helikobakter pilori pozitifliği devam eden antral gastrit hastalarında ek tedavi gereksinimi
Küçük Resim Yok
Tarih
2011
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi
Erişim Hakkı
Attribution-NonCommercial-NoDerivs 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Üçlü tedavi sonrası semptomları kaybolan ancak Helikobakter pilori (Hp) pozitifliği devam eden hastalara ek tedavi gereksinimini ortaya koymak. Yöntem: Kliniğimizde yapılan gastroskopilerinde yalnızca antral gastrit saptanan semptomatik 321 hastanın 248'inde biyopsi ile Hp (+) gösterildi. Hp(+) hastalara amoksisilin 1 gr 2x1 klaritromisin 500mg 2x1 14 gün boyunca ve pantoprazol 40 mg iki ay boyunca verildi. Tedavi sonrası yapılan gaita analizlerinde 74 hastada Hp eradikasyonunun başarısız olduğu görüldü. Eradikasyonun başarısız olduğu bu hastalardan 42'si semptomlarının tümü ile yok olduğunu ifade etti. Asemptomatik hastalar iki gruba ayrıldı. Birinci gruptakilere tetrasiklin 2x500mg ve metranidazol 4x500mg'lık ikinci basamak tedavisi verildi. İkinci gruptaki hastalara sadece beslenme önerilerinde bulunuldu. Her iki grup hasta 6 ay sonra tekrar kontrole çağrıldı. Bulgular: Birinci gruptaki 21 hastanın gaitada Hp analizleri tekrarlandı. Sadece 9 hastada pozitifliğin devam ettiği ancak bu gruptaki 9 (dördü H(p-)) hastada semptomların tekrar başladığı görüldü. Sadece diyet verilmiş olan ikinci gruptaki hastaların ise 10'u şikayetlerinin tekrarladığını ifade etti. Sonuç: Antibiyotik tedavisi sonrası semptomları düzelen ancak Hp pozitifliği devam eden hastalarda Hp eradikasyonu amacı ile ikinci basamak tedavi vermenin klinik yararı tartışmalıdır.
Objective: To determine the need of medical therapy in asymptomatic, Helicobacter pylori positive antral gastritis patients after a triple eradication therapy. Material and methods: Gasatroscopically detected symptomatic antral gastritis patients were evaluated. 248 of 321 were Helicobacter pylori (+).These patients were treated by amoxicilin 1 gr 2x1 clarithromycin 500 mg 2x1 for forteen days and pantoprazol 40 mg daily for two months. After the therapy 74 patients were still Hp(+) according to the stool analyzes and eradication was unsuccesfull.. 42 of those patients whom erradication therapy failed were completely asymptomatic. Asymptomatic patients were seperated into two groups. First group was treated by tetracycline 2x500mg and metranidazole 4x500 mg. The second group did not use any drugs and only dietary regulations were suggested. Six moths later both groups were controlled again. Results: The stool analyzes of 21 patients in the first group were repeated. Only 9 were positive but the symptoms reoccured in 9 (4 Hp(-)) patients. In the second group 10 patients were symptomatic after the dietary regulations. Conclusion: The need of second line medical therapy in asymptomatic, Hp positive antral gastritis patients after a triple erradication therapy is controversial
Objective: To determine the need of medical therapy in asymptomatic, Helicobacter pylori positive antral gastritis patients after a triple eradication therapy. Material and methods: Gasatroscopically detected symptomatic antral gastritis patients were evaluated. 248 of 321 were Helicobacter pylori (+).These patients were treated by amoxicilin 1 gr 2x1 clarithromycin 500 mg 2x1 for forteen days and pantoprazol 40 mg daily for two months. After the therapy 74 patients were still Hp(+) according to the stool analyzes and eradication was unsuccesfull.. 42 of those patients whom erradication therapy failed were completely asymptomatic. Asymptomatic patients were seperated into two groups. First group was treated by tetracycline 2x500mg and metranidazole 4x500 mg. The second group did not use any drugs and only dietary regulations were suggested. Six moths later both groups were controlled again. Results: The stool analyzes of 21 patients in the first group were repeated. Only 9 were positive but the symptoms reoccured in 9 (4 Hp(-)) patients. In the second group 10 patients were symptomatic after the dietary regulations. Conclusion: The need of second line medical therapy in asymptomatic, Hp positive antral gastritis patients after a triple erradication therapy is controversial
Açıklama
Anahtar Kelimeler
helikobakter pilori, eradikasyon, semptom, antral gastrit, helicobacter pylori, eradication, symptom, antral gastritis
Kaynak
Maltepe Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
3
Sayı
3
Künye
Manukyan, M. N., Deveci, U., Yener, N., Midi, A., Kapaklı, S., Gökçe, K. ve Kebudi, A. (2011). Üçlü tedavi sonrası semptomları kaybolan ancak Helikobakter pilori pozitifliği devam eden antral gastrit hastalarında ek tedavi gereksinimi / The need of medical therapy in asymptomatic, Helicobacter pylori positive antral gastritis patients after a triple eradication therapy. Maltepe Tıp Dergisi. 3(3), s. 16-18.
