保胆取石术后胆囊功能检测分析  

作　　者：孙玲国 孙伟军 鲁家贤 周亚萍 杜萍 胡德扬 

机构地区：[1]浙江省绍兴市柯桥区中医医院,312030

出　　处：《浙江临床医学》2015年第11期1878-1879,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省绍兴市科技局项目（2012D10051）

摘　　要：目的通过保胆取石术后与正常人群胆囊功能检测，探讨保胆取石术的可行性。方法保胆取石术后患者及健康者各85例，B超检查脂肪餐前、餐后胆囊壁厚度及胆囊内结石等情况。设定胆囊收缩率〉50％为胆囊收缩功能良好，〈50％为胆囊收缩功能差；胆囊壁厚度≥3mm为增厚，〈3mm为正常。结果85侧患者均无腹痛、发热、黄疸及再手术情况，胆囊结石复发11例。胆囊收缩率最大98％，最小42％，平均（67．7±18．9）％，胆囊收缩功能评级良好72例（84．7％），差13例（15.3％）。术前胆囊正常与伴有炎症的保胆术后，胆囊功能检查结果有一定差异。胆囊壶腹部结石嵌顿保胆术后胆囊功能与非结石嵌顿结果相类似。健康对照组胆囊结石5例（5．88％），胆囊息肉7例（8．23％）。胆囊收缩率最大96．8％，最小25．6％，平均82．3％，胆囊收缩功能评级良好75例（88．2％），差10例（11．8％）。保胆术后与健康对照组差异无明显统计学意义。结论内镜微创保胆取石术后超声检测胆囊功能具有重要的临床意义，胆囊功能正常的结石患者是保胆手术的最佳选择，胆囊结石伴炎症，即使胆囊壶腹部结石嵌顿的患者也可行保胆手术。Objective To investigate the feasibility of gallbladder by comparing the function test of gallbladder after gallbladder-preserving cholecystolithotomy in 85 cases with the 85 cases of control. Method 85 cases of postoperative of gallbladder-preserving cholecystolithotomy were followed-up while randomized 85 cases of normal pollution in non-selective similar age and gender, both of them took gallbladder function tests, B-ultrasound and measurement of the gallbladder wall thickness before and after fat food, the presence or absence of gallbladder stone etc. The criteria was set as： cholecystokinin rate〉 50% is well, 〈50% is dysfunction, gallbladder wall thickness 〉 3mm is Thickened, 〈3mm is normal. Result 85 cases had no abdominal pain, fever, jaundice and moperation cases. The detection of 11 cases of gallstones before or after fat. Cholecystokinin rate in maximum 98%, in minimum 42%, on average 67.7 ± 18.9%, well gallbladder function in 72 （ 84.7% ） , dysfunction in 13 （ 15.3% ） .There were some differences in the preoperative gallbladder gallbladder function test results between nomal and accompanied by inflammation. Gallbladder function with the results of the non- impacted stones in the gallbladder bile Paul ampulla impacted stones postoperatively were similar. Normal population control group 85 cases, B-gallbladder function tests and found gallstones in 5 cases （ 5.88% ） , gallbladder polyps in 7 cases （ 8.23% ） , cholecystokinin maximum shrinkage rate of 96.8%, a minimum of 25.6%, with an average of 82.3%, gallbladder contractile function of good ratings 75 cases （ 88.2% ） , poor function in 10 patients （ 11.8% ） results showed no significant difference with the normal population gallbladder surgery control group. Conclusion Minimally invasive endoscopic ultrasound by Doppler Paul is important clinical implications for Paul gall stone surgery, gallbladder of normal function is the best option. For some cases of gallstones with inflammation, even incarceration of stones on g

关 键 词：胆囊结石 保胆取石术 胆囊结石嵌顿 胆囊功能检测 

分 类 号：R657.42[医药卫生—外科学]