早发现早治疗!全家染幽门螺杆菌父亲查出胃早癌

2022-08-23 网络 网络

山东济南一36岁男子体检发现感染幽门螺杆菌,经检测其他家庭成员4人均已感染。

山东济南一36岁男子体检发现感染幽门螺杆菌,经检测其他家庭成员4人均已感染。其父亲在医生建议下做了胃镜检查,查出早期胃癌,经过手术目前恢复良好。主治医生介绍幽门螺杆菌感染会导致慢性活动性胃炎、消化性溃疡等疾病,如终生不杀菌约5%的患者会发生胃癌。医生提示,幽门螺杆菌经口传播,个人如发现感染,建议其他家庭成员一同检测做主动筛查。医院就诊或在疫情下选择居家自测。如果发现感染,尽早治疗。

 

早在1994年WHO下属的国际癌症研究机构就将幽门螺杆菌定义为一类致癌原,2022年美国卫生和公共服务部将幽门螺杆菌列为明确致癌物。

如何预防这个致癌物传染一家人,一直是大家热议的焦点。

今天我们就跟大家仔细说说幽门螺杆菌的家庭预防。

最容易被感染的家庭成员是?

家里的小朋友。

虽然幽门螺杆菌可以感染家庭中的任何成员,但《中国居民家庭幽门螺杆菌感染的防控和管理专家共识( 2021年)》明确指出,幽门螺杆菌的感染主要发生在儿童和青少年时期,也会发生在成年后,但相对较少。

为什么成年人不容易被传染,目前还没有定论。一般认为是成年人胃部环境已经稳定,对新来的幽门螺杆菌有很强抵抗能力,以及成年人的手卫生习惯明显好于儿童。

数据显示,儿童在家庭内部获得感染,主要发生在12岁之前。可以来自于家庭内所有成员,但最主要的来源还是父母——父母均感染幽门螺杆菌者,子女感染率为69.34%。

除去父母之外,家庭中年龄相仿的儿童之间也非常容易传播幽门螺杆菌,且常常表现为哥哥姐姐传染给弟弟妹妹。

再然后,传染给儿童风险较大的还有祖母/外祖母,这也大致体现了家庭成员跟儿童的亲近程度。

家里有人感染后要怎么办?

中国人群中幽门螺杆菌感染率已经达到59%,家庭感染率更高,达62.96%。

虽然我们更希望预防感染,但大多数人现在已经有了感染,要把精力放在减少自己的感染影响家人,也就是尽量避免儿童感染那里。

这就要求成年人知晓自己的幽门螺杆菌感染情况,如果因为疫情不想去医院做检查,可以用幽幽管在家做自测。

如果证实感染了幽门螺杆菌,应该及时进行杀菌治疗, 哪怕是没有症状。

这是为什么呢?

来听听国家卫健委“慢病健康管理-癌症筛查早诊培训项目”副主任委员兼秘书长张凯教授的回答:

在5月刚刚出炉的《第六次全国幽门螺杆菌感染处理共识报告》中,也强调了有感染的人群都要杀菌。

家庭成员一人阳性,则建议全家都行检测和根除治疗。

全家一起治,复发率更低。一项研究显示,个人根除治疗2年幽门螺杆菌复发率为19.7%,家庭共同治疗2年幽门螺杆菌复发率仅为7.4%。

防治幽门螺杆菌的最佳情况,当然是在家庭中有儿童之前进行;如果已经有了孩子,那也不用太紧张,因为小孩子有一定自发清理的能力。

这时候大人能做的最好方式,就是去治疗自己的感染,避免小孩生活在持续可能被感染的环境里。

若家中成年人评估后不适合做幽门螺杆菌治疗,或者治疗失败,那就暂时尽量不做小朋友的第一照护人,避免口对口喂食等不良习惯,有条件的话,尽可能与儿童分餐,让孩子使用独立餐具。

参考资料:

1.国家消化系疾病临床医学研究中心(上海),国家消化道早癌防治中心联盟,中华医学会消化病学分会幽门螺杆菌和消化性溃疡学组,等.中国居民家庭幽门螺杆菌感染的防控和管理专家共识(2021年)[J].中华消化杂志, 2021,41(4):221-233.

2.王凯娟, 王润田. 中国幽门螺杆菌感染流行病学Meta分析[J]. 中华流行病学杂志, 2003, 24(6):443-446.

3.中华医学会, 中华医学会杂志社, 中华医学会全科医学分会,等. 幽门螺杆菌感染基层诊疗指南(2019年)[J]. 中华全科医师杂志,2020,19(5):397-402.

4.中华医学会消化病学分会幽门螺杆菌学组.第六次全国幽门螺杆菌感染处理共识报告(非根除治疗部分). 中华消化杂志2022年5月第42卷第5期.

5.《防癌的真相》

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    2023-01-08 kcb069
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    2022-08-24 ms5000001621028728

    儿童感染幽门螺杆菌需治疗么

    0

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    2022-08-23 ms1000001895009881

    👍

    0

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