微创保胆术后胆囊结石、息肉复发相关因素分析

发布时间：2018-02-27 08:28

本文关键词： 胆囊结石胆囊息肉复发腹腔镜胆道镜保胆取石术息肉摘除术　出处：《山东医药》2017年23期 　论文类型：期刊论文

【摘要】：目的探讨微创保胆术后胆囊结石、息肉复发的相关因素。方法回顾采用腹腔镜联合胆道镜保胆取石术或息肉切除术治疗的4 686例胆囊结石或胆囊息肉患者的临床资料。包括复发情况以及性别、民族、手术时间、患者的依从性、术后是否积极干预、是否门诊随访。将4 686例患者按术后是否发生胆囊结石或者息肉复发分为复发组和非复发组,比较两组患者性别女、少数民族、患者依从性好、术后积极干预、门诊随访的构成比及手术时间。选择其中有统计学差异者进行Logistic回归分析,确定采用腹腔镜联合胆道镜保胆取石术或息肉切除术治疗的胆囊结石或胆囊息肉患者术后复发的相关因素。结果本组患者随访3~93个月,共有613例复发,复发率为13.08%。单因素分析显示采用腹腔镜联合胆道镜保胆取石术或息肉切除术治疗的胆囊结石或胆囊息肉患者术后胆囊结石或息肉复发与患者手术时间、民族、依从性、是否积极干预及门诊随访有关(P均0.05),与性别无关(P0.05)。Logistic多因素回归分析显示手术时间长(OR=0.027,95%CI:1.004~1.051,P=0.019)、少数民族(OR=0.385,95%CI:1.016~2.125,P=0.041)是采用腹腔镜联合胆道镜保胆取石术或息肉切除术治疗的胆囊结石或胆囊息肉患者术后胆囊结石或息肉复发的独立危险因素,依从性好(OR=-1.178,95%CI:0.164~0.577,P=0.000)、术后积极干预(OR=-1.127,95%CI:0.156~0.674,P=0.003)、门诊随访(OR=-0.722,95%CI:0.263~0.896,P=0.021)是采用腹腔镜联合胆道镜保胆取石术或息肉切除术治疗的胆囊结石或胆囊息肉患者术后胆囊结石或息肉复发的保护性因素。结论微创保胆术后胆囊结石、息肉复发的危险因素是手术时间长和少数民族,保护性因素是依从性好、术后积极干预、门诊随访。
[Abstract]:Objective to investigate gallstone after minimally invasive cholecystectomy. Methods the clinical data of 4686 patients with cholecystolithiasis or polyposis treated by laparoscopic choledochoscopic cholelithiasis or polyposis were reviewed. According to whether gallstone or polyp recurred after operation, 4686 patients were divided into recurrent group and non-recurrent group. The patients had good compliance, positive intervention after operation, composition ratio of outpatient follow-up and operation time. The patients with statistical differences were selected for Logistic regression analysis. The factors related to postoperative recurrence of cholecystolithiasis or polyposis treated by laparoscopy combined with choledochoscopic cholelithiasis or polyposis were determined. Results 613 patients were followed up for 3 ~ 93 months. The recurrence rate of cholecystolithiasis or polyp in patients with cholecystolithiasis or polyposis treated by laparoscopy combined with choledochoscopic cholelithiasis or polyposis was 13.08. The recurrence of gallstone or polyp was associated with the operative time, nationality and compliance. The multivariate regression analysis showed that the operation time was 0.027% 95% CI: 1.004% 1.051% P0.019%, and the minority group was 0.385% 0.385% 95% CI 1.0162.125P0.041%) was the gallbladder knot treated by laparoscopy combined with choledochoscope with cholelithiasis or polyposis resection. Independent risk factors for recurrence of gallstone or polyp in patients with stone or polyp. Compliance with OR-1.17895 CIW 0.164N 0.577P0.000, active postoperative intervention OR-1.12795 CI: 0.1560.674P0.003, outpatient follow-up: OR-0.722C95: CI0.2630.896P0.021) is a protective factor for the treatment of gallstone or recurrent gallbladder polyps with laparoscopic choledochoscope or polyposis resection. Conclusion gallstone after minimally invasive cholecystectomy, The risk factors of polyp recurrence were long operation time and ethnic minorities, and protective factors were good compliance, positive intervention after operation and outpatient follow-up.
【作者单位】：凉山州第二人民医院;中国人民解放军兰州军区乌鲁木齐总医院新疆特殊环境医学重点实验室;
【基金】：新疆维吾尔族自治区科技计划项目(201042145)
【分类号】：R657.4

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