重度脂肪肝患者胆囊结石超声诊断结果及其影响因素260例分析  

Gallbladder stones in patients with severe fatty liver: Ultrasound diagnosis and influencing factors

作　　者：张含君[1] 

机构地区：[1]义乌市中心医院超声科,浙江省义乌市322000

出　　处：《世界华人消化杂志》2017年第30期2731-2734,共4页World Chinese Journal of Digestology

摘　　要：目的观察260例重度脂肪肝患者胆囊结石超声诊断结果及其影响因素分析.方法选择2013-03/2017-05在义乌市中心医院住院的260例重度脂肪肝患者,均经过超声证实有胆囊结石,然后行手术切除后通过病理结果证实超声检查对胆囊结石诊断的准确率、误诊率,并分析其原因和影响因素.结果超声检查的260例患者术后经病理证实有胆囊结石者246例,准确率为94.62%,其中典型胆囊结石诊断准确率为97.59%,充满型胆囊结石为92.0%,多发性胆囊结石为92.86%,泥沙样胆囊结石最低,为75.0%.另有14例误诊,误诊率5.38%(14/260).影响因素性别中男性患者胆囊结石的发生率为98.77%,女性发生率为87.76%(P<0.01);年龄<40岁者胆囊结石的发生率为89.29%,40岁≤年龄≤60岁者胆囊结石的为98.41%,>60岁者胆囊结石的为92.31%.结论超声检查能提高重度脂肪肝患者胆囊结石的诊断准确率,在脂肪肝、性别及年龄等影响因素下要认真检查,以尽可能降低误诊率.AIM To explore the ultrasonographic diagnosis of gallbladder stones in patients with severe fatty liver and to analyze its influencing factors.METHODS Two hundred and sixty patients with severe fatty liver who were diagnosed with gallbladder stones by ultrasound from March 2013 to May 2017 at Yiwu Central Hospital were included. All the patients underwent surgery for removal of gallbladder stones. The surgical results were compared with ultrasound results to calculate the diagnostic accuracy of ultrasound and its rates of misdiagnosis and missed diagnosis, and to analyze the factors influencing ultrasound diagnosis.RESULTS Ultrasound diagnosis of gallbladder stones was confirmed by pathology in 246 of 260 patients, with a diagnostic accuracy rate of 94.62%; typical gallbladder stones were accurately diagnosed in 97.59% of cases, fully filled gallbladder stones in 92.0%, multiple stones in 92.86%, and sediment-like gallstones in 75.0%. Eight cases were misdiagnosed, with a misdiagnosis rate of 5.38%（14/260）. The incidence of gallbladder stones in male patients was 98.77%, and the incidence in females was 87.76%（P 〈 0.01）. The incidence rate of gallbladder stones was 89.29% in patients under the age of 40 years, 98.41% in those between 40 and 60 years, and 92.31% in those over 60 years.CONCLUSION Ultrasound examination can improve the diagnosis of gallbladder stones in patients with severe fatty liver, and factors such as fatty liver, gender and age should be carefully considered to avoid misdiagnosis and missed diagnosis.

关 键 词：彩色多普勒超声 重度脂肪肝 胆囊结石 准确率 误诊率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学] R575.62[医药卫生—临床医学]