结石嵌顿性胆囊炎患者硬镜微创保胆手术后胆囊收缩功能变化及其影响因素

发布时间：2018-07-27 20:16

【摘要】：目的探讨结石嵌顿性胆囊炎硬镜微创保胆手术后胆囊收缩功能变化及其影响因素。方法选取结石嵌顿性胆囊炎患者195例(观察组),健康者100例(对照组),观察组给予硬镜微创保胆手术治疗。观察组于术前及术后随访6、12、24个月时,对照组于体检时,分别行Lundh试餐超声检查,计算胆囊最大收缩率,判断胆囊收缩功能。比较术后24个月时胆囊收缩功能良好及不良者临床病理参数,分析术后胆囊收缩功能的影响因素。结果观察组均取石成功,未出现胆管损伤,术后无特殊不适及并发症发生。观察组术前胆囊最大收缩率为(36.2±6.4)%,对照组为(83.3±7.2)%,两者比较P0.05。观察组术后6、12、24个月时胆囊最大收缩率分别为(43.4±7.6)%、(51.9±6.6)%、(58.6±9.7)%,均明显高于术前;胆囊收缩功能良好者比例分别为30.26%(59/195)、50.26%(98/195)、82.05%(160/195),均明显高于术前的15.38%(30/195),且各时间点比较P均0.05。年龄、术前TC、复发结石、糖尿病、手术时间是术后胆囊收缩功能的独立影响因素(P0.05或0.01)。结论硬镜微创保胆手术能够促进结石嵌顿性胆囊炎患者胆囊收缩功能恢复,年龄、术前TC、复发结石、糖尿病、手术时间是术后胆囊收缩功能的影响因素。
[Abstract]:Objective to investigate the changes of gallbladder systolic function and its influencing factors after minimally invasive cholecystectomy with hard endoscope in patients with incarcerated cholecystitis. Methods 195 cases of stone incarcerated cholecystitis (observation group) and 100 healthy cases (control group) were selected. The patients in the observation group were followed up for 12 months before operation and 24 months after operation. The control group was examined by Lundh during physical examination to calculate the maximum contraction rate of gallbladder and to judge the function of gallbladder contraction. To compare the clinicopathological parameters of patients with good or poor gallbladder systolic function 24 months after operation and analyze the influencing factors of postoperative gallbladder systolic function. Results in the observation group, the stone was removed successfully, no bile duct injury occurred, no special discomfort and complications occurred after operation. The maximal contraction rate of gallbladder was (36.2 卤6.4) in the observation group and (83.3 卤7.2) in the control group. The maximal contraction rate of gallbladder was (43.4 卤7.6), (51.9 卤6.6) and (58.6 卤9.7) months after operation in the observation group, respectively, and the percentage of patients with good gallbladder contraction was 30.26% (59 / 195) and 50.26% (98 / 195) respectively, which was significantly higher than that before operation (15.38% (30 / 195), P < 0.05). Age, preoperative TC, recurrent calculi, diabetes mellitus and operative time were independent influencing factors of gallbladder contraction function after operation (P0.05 or 0.01). Conclusion minimally invasive cholecystitis with hard endoscopy can promote the recovery of gallbladder systolic function in patients with incarcerated cholecystitis. Age, preoperative TC, recurrent stones, diabetes mellitus and operation time are the influencing factors of gallbladder contraction function after operation.
【作者单位】：广州市南沙区第六人民医院;
【基金】：广州市番禺区科技计划项目(2011-Z-03-53)
【分类号】：R657.4

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