急性坏疽性胆囊炎的单一中心多因素分析  

Single Center Multifactorial Analysis of Acute Gangrenous Cholecystitis

作　　者：罗忠飞 蔡思奕 陈贸易 胡林[1] LUO Zhongfei;CAI Siyi;CHEN Maoyi;HU Lin(Department of Hepatobiliary and Pancreatic Surgery,Jinjiang Municipal Hospital,Jinjiang Fujian 362200,China)

机构地区：[1]晋江市医院肝胆胰外科,福建晋江362200

出　　处：《中国卫生标准管理》2024年第19期127-130,共4页China Health Standard Management

摘　　要：目的探讨影响急性坏疽性胆囊炎的危险因素,提高术前诊断坏疽性胆囊炎的准确性。方法回顾性分析2019年6月—2022年8月于晋江市医院肝胆胰外科被诊断为胆囊炎并行手术治疗的354例患者术前临床资料,包括52坏疽性胆囊炎与302例非坏疽胆囊炎,比较2组的各项资料差异,通过logistic回归分析坏疽性胆囊发生的主要风险因素。结果2组的性别、年龄、体温、糖尿病、右上腹肌紧张、腹部B超或影像学检查提示胆囊壁的厚度、胆囊颈结石嵌顿及胆囊周围积液比较,差异有统计学意义(P<0.05)。将存在差异的资料带入logistic回归方程计算,得出年龄(P=0.007)、胆囊颈部结石嵌顿(P=0.016)、胆囊周围积液(P<0.001)是坏疽性胆囊炎独立危险因素。结论急性坏疽性胆囊炎病程进展迅速、早期诊断困难、病死率高。临床需要加强对急性坏疽性胆囊炎的认识,早期诊断和及时处理尤为重要。年龄、胆囊颈部结石嵌顿、胆囊周围积液为坏疽性胆囊炎独立危险因素。Objective To explore the risk factors for acute gangrenous cholecystitis(AGC),and to improve the preoperative diagnosis accuracy of AGC.Methods The reoperative clinical data of 354 patients diagnosed with cholecystitis and treated with surgery in department of hepatobiliary and Pancreatic Surgery,Jinjiang Municipal Hospital from June 2019 to August 2022 were Retrospective analysed,including 52 cases of gangrenous cholecystitis and 302 cases of non gangrenous cholecystitis.Comparing the data differences between the two groups,the different data were brought into the logistic regression equation to determine the main factors affecting the occurrence of acute gangrenous cholecystitis.Results There were significant differences between the two groups in gender,age,body temperature,diabetes,right upper quadrant muscular rigidity,abdominal ultrasound/imaging examination findings gallbladder wall thickness,gallbladder neck calculus impaction,fluid accumulation around gallbladder(P<0.05).Taking the data with differences into the logistic regression equation,it was concluded that age(P=0.007),gallbladder neck calculus impaction(P=0.016),fluid accumulation around gallbladder(P<0.001),were the main factors affecting the occurrence of acute gangrenous cholecystitis.Conclusion Acute gangrenous cholecystitis progresses rapidly,is difficult to diagnose early,and has a high mortality rate.It is necessary to strengthen the understanding of acute gangrenous cholecystitis in clinical practice,and early diagnosis and timely treatment are particularly important.Age,stone entrapment in the neck of the gallbladder,and fluid accumulation around the gallbladder are independent risk factors for gangrenous cholecystitis.

关 键 词：急性坏疽性胆囊炎 危险因素 回归分析 腹腔镜 胆囊切除术 胆囊炎 

分 类 号：R657[医药卫生—外科学]