胆囊隆起性病变危险因素分析及手术指征探讨

发布时间：2019-07-01 13:37

【摘要】：目的:总结胆囊隆起性病变(polypoid lesions of gallbladder,PLG)各病理类型的彩超特点,分析PLG彩超特点、临床特征与病理学分型之间的关系,明确PLG肿瘤性与非肿瘤性在年龄、性别、大小、病变数目、彩超回声强弱、有无症状、有无血流信号、是否合并胆囊结石等因素中有意义的诊断指标,进一步探讨PLG胆囊切除的手术指征,减少非肿瘤性息肉的胆囊切除。方法:收集山西医科大学第一医院2010年1月到2016年5月间93例行手术治疗的PLG患者的临床与病理资料,回顾性分析其彩超特点、临床特征和病理学特点。结果:非肿瘤性息肉81例(87.10%),慢性胆囊炎伴胆固醇息肉形成(或慢性胆囊炎合并胆固醇沉着症)者53例(56.99%),肿瘤性息肉12例(12.90%);肿瘤性息肉组与非肿瘤性息肉组在年龄、直径、彩超回声强弱、有无血流信号方面比较均有统计学意义(P0.05)。结论:息肉直径1.0cm、年龄55岁、彩超回报低回声或不均回声、有血流信号是胆囊隆起性病变的危险因素,应当作为手术切除的指征。胆囊隆起性病变的发生与腺瘤性大肠息肉的发生存在一定的相关性;胆囊切除术亦应在大肠腺瘤性息肉患者切除大肠息肉后腹部彩超提示胆囊隆起性病变时进行,以除外腺瘤性息肉在胆囊发生。
[Abstract]:Objective: to summarize the characteristics of color Doppler ultrasound (CDU) of various pathological types of gallbladder protruding lesions (polypoid lesions of gallbladder,PLG), analyze the relationship between PLG color Doppler ultrasound characteristics, clinical features and pathological classification, and determine the significant diagnostic indexes of age, sex, size, number of lesions, echo intensity, symptom, blood flow signal, whether or not complicated with gallstones and other factors, such as age, sex, size, number of lesions, echo intensity, symptoms, blood flow signal or not. To further explore the indication of PLG gallbladder resection and reduce the gallbladder resection of non-neoplastic polyps. Methods: the clinical and pathological data of 93 patients with PLG treated surgically from January 2010 to May 2016 in the first Hospital of Shanxi Medical University were collected and their color Doppler ultrasound features, clinical features and pathological features were analyzed retrospectively. Results: 81 cases (87.10%) of non-neoplastic polyps, 53 cases (56.99%) of chronic cholecystitis complicated with cholesterol polyposis and 12 cases (12.90%) of neoplastic polyps were statistically significant in age, diameter, color Doppler echo intensity and blood flow signal between tumor polyp group and non-tumor polyp group (P 0.05), and there were significant differences in age, diameter, color Doppler echo intensity and blood flow signal between tumor polyp group and non-tumor polyp group (P < 0.05), and there were significant differences in age, diameter, color Doppler echo intensity and blood flow signal between tumor polyp group and non-tumor polyp group (P 0.05). Conclusion: polyp is 1.0 cm in diameter and 55 years old. color Doppler ultrasound returns hypoechoic or uneven echo. Blood flow signal is a risk factor for gallbladder protrusive lesions and should be used as an indication of surgical resection. There is a certain correlation between the occurrence of protruding lesions of gallbladder and the occurrence of adenomatous colorectal polyps. Cholecystectomy should also be performed in patients with colorectal adenomatous polyps after resection of colorectal polyps.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.4

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