胆囊结石合并胆心综合征的外科治疗体会  

Experience of surgical treatment of gallstones complicated with bilio-cardiac syndrome

作　　者：王鹏[1] 邵荣[1] 姜协[1] 薛剑 WANG Peng;SHAO Rong;JIANG Xie;XUE Jian(Department of General Surgery,Wujin TCM Hospital of Changzhou City in Jiangsu Province,Changzhou 213161,China;No.307 Hospital of PLA,Beijing 100071,China)

机构地区：[1]江苏省常州市武进中医医院普外科,江苏常州213161 [2]解放军第三〇七医院,北京100071

出　　处：《中国现代医生》2018年第29期41-43,47,共4页China Modern Doctor

摘　　要：目的探讨胆囊结石合并胆心综合征的外科治疗体会。方法将2014年10月~2017年10月在我院治疗的40例胆囊结石合并胆心综合征患者随机分为两组,对照组采用内科保守治疗,观察组采用腹腔镜下胆囊切除术治疗,比较两组患者的临床疗效、症状及体征改善率、复发率。结果观察组治疗有效率为100%,明显高于对照组的80%,差异有统计学意义(P<0.05);观察组治疗后心悸、胸闷、胸痛等心前区症状评分,以及心电图恢复评分与对照组相比均明显升高,差异有统计学意义(P<0.05);两组均随访6个月~1年,观察组无复发病例,对照组有4例复发,复发率为20%,差异有统计学意义(P<0.05)。结论胆囊结石合并胆心综合征的外科治疗效果显著,能有效解除胆道病变对心脏功能的继发性损害,促进心功能的恢复,改善临床症状,且无明显复发,具有积极的临床意义。Objective To investigate the experience of surgical treatment of gallstones complicated with bilio-cardiacsyndrome. Methods 40 patients with gallstones complicated with bilio-cardiac syndrome who were treated in our hospital from October 2014 to October 2017 were randomly divided into two groups. The control group was given conservative treatment with internal medicine. The observation group was given laparoscopic cholecystectomy. The clinical efficacy, improvement rate of symptoms and signs and recurrence rate were compared between the two groups. Results Theeffective rate in the observation group was 100%, which was significantly higher than that of 80% in the control group.The difference was statistically significant （P〈0.05）; the precordial symptom scores such as palpitations, chest tightness,chest pain and the electrocardiogram recovery scores in the observation group were significantly higher than those inthe control group, and the differences were statistically significant （P〈0.05）; both groups were followed up for 6 monthsto 1 year. There were no cases of recurrence in the observation group, and 4 cases in the control group. The recurrencerate was 20%, and the difference was statistically significant （P〈0.05）. Conclusion The surgical treatment of gallstonescomplicated with bilio-cardiac syndrome is effective. It can effectively relieve the secondary damage of biliary tract lesions on cardiac function, promote the recovery of cardiac function, improve clinical symptoms, and has no obvious recurrence. It has a positive clinical significance.

关 键 词：胆囊结石 胆心综合征 腹腔镜下胆囊切除术 心前区症状变化 

分 类 号：R657.4[医药卫生—外科学]