保胆术后胆囊结石及息肉复发的超声征象及相关因素分析  

Ultrasonographic signs as factors for recurrence of gallstones and polypoid lesions of the gallbladder after gallbladder-preserving surgery

作　　者：吕志红[1] 俞磊[1] 韩鄂辉[1] 洪玮[1] 胡小娟[1] 裴斐[2] 

机构地区：[1]黄石市中心医院超声影像科,湖北黄石435000 [2]黄石市中心医院肝胆外科,湖北黄石435000

出　　处：《临床肝胆病杂志》2016年第4期746-749,共4页Journal of Clinical Hepatology

摘　　要：目的探讨影响保胆术后胆囊结石及息肉复发的超声征象相关因素。方法回顾性收集2011年1月^(-2)015年2月于黄石市中心医院行保胆术的700例患者的术前术后超声检测的胆囊大小、胆囊透声、胆囊壁厚度、胆汁淤积、胆囊收缩功能、胆总管内径等相关征象及术后有无胆囊结石及胆囊息肉样病变复发的情况。采用Fisher确切概率法及Cox比例风险回归模型对保胆术后复发的相关因素进行单因素及多因素分析。结果 700例患者的随访时间最短6个月,最长48个月,平均(18±12)个月,其中1例术后1个月复发胆囊结石、2例术后6个月复发胆囊结石、1例术后12个月复发胆囊结石、1例术后24个月复发胆囊息肉,胆囊结石及息肉样病变平均复发时间为术后9.8个月,复发率为0.71%(5/700)。单因素分析结果显示胆囊壁厚度≥4 mm、胆囊收缩功能<30%、胆汁淤积在胆囊结石及息肉复发与未复发的患者之间差异均有统计学意义(P值均<0.05)。多因素分析结果显示胆囊壁厚度≥4 mm、胆汁淤积、胆囊收缩功能<30%为保胆术后复发的独立影响因素(P值分别为0.000 3、0.040 0、0.040 0)。结论超声显示胆囊壁厚度≥4 mm、胆囊收缩功能<30%、胆汁淤积与胆囊结石及胆囊息肉样病变复发密切相关。Objective To investigate ultrasonographic signs as the factors for the recurrence of gallstones and polypoid lesion of the gallbla-dder in patients undergoing gallbladder- preserving surgery. Methods Related signs including gallbladder size,sound transmission of the gallbladder,gallbladder wall thickness,cholestasis,gallbladder contraction function,and common bile duct diameter measured by preoperative and postoperative ultrasonography,as well as the recurrence of gallstones and polypoid lesions of the gallbladder after surgery,were collected from 700 patients who underwent gallbladder- preserving surgery in Huangshi Central Hospital from January 2011 to February 2015.The Fisher＇s exact test and Cox proportional hazards regression model were applied for univariate and multivariate analysis of related factors for recurrence after gallbladder- preserving surgery. Results The shortest and longest follow- up time was 6 months and 48 months,respectively,and the mean follow- up time was 18 ± 12 months. Among the 700 patients,1 experienced recurrence of gallstones at 1 month after surgery,2 experienced recurrence of gallstones at 6 months after surgery,1 experienced recurrence of gallstones at 12 months after surgery,and 1 experienced recurrence of polypoid lesions of the gallbladder at 24 months after surgery. The mean time to recurrence of gallstones and polypoid lesions was 9. 8 months after surgery,and the recurrence rate was 0. 71%（ 5 /700）. The univariate analysis showed that gallbladder wall thickness ≥4 mm,gallbladder contraction function 30%,and cholestasis were significantly associated with the recurrence of gallstones and polypoid lesions（ all P〈0. 05）. The multivariate analysis showed that gallbladder wall thickness ≥4 mm,cholestasis,and gallbladder contraction function 30% were independent factors for recurrence after gallbladder- preserving surgery（ P = 0. 000 3,0. 040 0,and 0. 040 0）. Conclusion Ultrasonography shows that gallbladder wall thickness ≥4 mm,gallbladder contraction func

关 键 词：胆囊疾病 复发 超声检查 

分 类 号：R657.4[医药卫生—外科学]