78例并发肝功能损害的急性结石性胆囊炎手术治疗临床分析  

Clinical analysis of surgery for acute calculons cholecystitis with liver function damage in 78 patients

作　　者：宋海良 郭强 叶浩波 李春青 

机构地区：[1]广东省东莞市大朗医院,广东东莞523770

出　　处：《吉林医学》2012年第16期3389-3391,共3页Jilin Medical Journal

基　　金：广东省东莞市科技局立项课题[项目编号:2010105150158]

摘　　要：目的:总结手术治疗并发肝功能损害的急性结石性胆囊炎的临床经验,探讨急性结石性胆囊炎炎性反应程度与肝功能损害的关系。方法:对78例行手术治疗并发肝功能损害的急性结石性胆囊炎患者的临床资料进行回顾性分析。将78例患者按炎性反应程度分为轻、中、重三组,针对4项肝功能指标:总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)和血浆白蛋白(ALB),组间比较统计学处理。结果:重度胆囊炎ALT,TBIL、AST均较轻度、中度胆囊炎明显升高,ALB均较对照组明显降低,差异有统计学意义(P<0.01)。而中度胆囊炎ALT,TBIL、AST均较轻度胆囊炎明显升高,ALB均较对照组明显降低,差异有统计学意义(P<0.05)。结论:急性结石性胆囊炎炎性反应程度与肝功能损害成正相关,保肝、消炎、尽早手术切除胆囊是肝功能恢复的较好方法。术前可通过肝功能损害程度作为判断炎性反应程度参考因素之一,以判断病情,预测后果,评估手术方案及手术时机,拟定妥切治疗方案。Objective To summarize the clinical experience of liver function damage of acute calculous choleeystitis with operation, to explore the relation between the degree of inflammation in acute calculous choleeystitis and liver function damage. Method To retrospec- tively review and analyze 78 patients with liver function damage of acute calculous choleeystitis with operation. According to degree of in- flammation of acute calculous cholecystitis,78 cases of acute calculous cholecystilis were divided into light, median and serious group. Four liver function indexes ： TBIL, AST, ALT and ALB were determined and compared. Results ALT, TBIL, AST were remarkably higher in the groups of serious inflammation of the gallbladder than light and median group, ALB was remarkably decreased in the groups of serious in- flammation of the gallbladder than light and median group, there were most remarkable difference in the groups of serious inflammation of the gallbladder than light and median group （P 〈0. 01 ）. ALT, TBIL,AST were remarkably higher in the groups of median inflammation of the gallbladder than light group, ALB was remarkably decreased in the groups of median inflammation of the gallbladder than light group, there were remarkable difference in the groups of median inflammation of the gallbladder than light group （P 〈 0. 05 ）. Conclusion There is a positive relationship between the inflammation degree of acute calculous choleeystitis and the damage of liver function. It is suggested that the better way for the recovery of liver function is liver proteetion,cantrol of inflammation and performing choleeysteetomy in time.

关 键 词：急性结石性胆囊炎 肝功能 损害 

分 类 号：R657.4[医药卫生—外科学]