胆囊炎和胆系结石手术患者肝组织病理分析57例

发布时间：2018-10-26 18:55

【摘要】：目的：从肝脏病理组织学角度,探讨在因胆系良性病变手术的患者中,胆囊炎或胆系结石与肝脏损害之间的联系。方法：回顾性分析2012-06-01/2013-05-31因胆囊炎或胆囊结石行胆囊切除术,和因胆管结石行胆管切开取石手术切除的患者共1479例,其中120例因术前临床资料(超声,CT,MRI)或术中发现肝脏形态异常而行肝组织学检查,排除乙型病毒性肝炎、丙型病毒性肝炎、酒精性肝病、药物性肝病、自身免疫性肝病、肝包虫、肝囊肿、肝血管瘤、肝脏及胆道肿瘤,有57例肝脏损伤原因不明。我们对这57例进行了分析及探讨。结果：(1)本研究的胆道手术患者中,大部分病理学上存在肝脏损伤(71.93%),其中肝纤维化者占50.88%。(2)胆囊结石或炎症较胆管结石或炎症,合并脂肪变的显著性增高(47.1%vs17.5%,P0.05)。(3)脂肪变合并炎症坏死的显著性增高(26.7%vs7.1%,P0.05)。(4)糖尿病合并炎症坏死的显著性增高(42.9%vs8.0%,P0.05)。结论：本研究从肝组织病理学角度观察这些因胆道疾病行手术切除患者的肝脏损伤特征,结合其临床症状符合非酒精性脂肪性肝病的特点。
[Abstract]:Objective: to investigate the relationship between cholecystitis or gallstone and liver damage in patients with benign biliary diseases from the point of view of liver histopathology. Methods: a total of 1479 patients with cholecystitis or cholecystolithiasis underwent cholecystectomy or cholecystolithiasis from 2012-06-01 / 2013-05-31 and choledocholithiasis from choledocholithiasis were treated with cholecystectomy. Among them, 120 patients underwent cholecystectomy because of preoperative clinical data (ultrasound, CT,). MRI) or liver histological examination to exclude hepatitis B, hepatitis C, alcoholic liver disease, drug-induced liver disease, autoimmune liver disease, hepatic hydatid, hepatic cyst, hepatic hemangioma. Liver and biliary tract tumors, 57 cases of liver injury unknown cause. We analyzed and discussed these 57 cases. Results: (1) liver injury was found in most of the patients with biliary tract surgery (71.93%), and hepatic fibrosis was found in 50.88% of the patients. (2) gallstone or inflammation was more common than cholelithiasis or inflammation. There was significant increase (47.1 vs 17.5). (3) in adiposis associated with inflammation and necrosis (26.7vs7.1), and there was no significant difference between them (P 0.05, P 0.05; P 0.05); P0.05). (4) Diabetes mellitus complicated with inflammatory necrosis was significantly increased (42.9 vs 8.0). Conclusion: from the point of view of liver histopathology, we observed the characteristics of liver injury in these patients who underwent surgical resection of biliary diseases, and combined with their clinical symptoms, they were consistent with the characteristics of non-alcoholic fatty liver disease.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.5

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