胆囊结石患者腹腔镜与胆道镜联合保胆取石术后复发的高危因素分析  

Analysis of the High Risk Factors of Postoperative Recurrence after Laparoscopic and Choledochoscopy Combined with Gallbladder-Preserving Lithotomy in Patients with Gallbladder Stones

作　　者：潘苗苗 PAN Miaomiao(Department of Hepatobiliary Surgery,Xishui County Traditional Chinese Medicine Hospital,Huanggang 438000,China)

机构地区：[1]浠水县中医院肝胆外科,湖北黄冈438000

出　　处：《反射疗法与康复医学》2025年第5期144-147,152,共5页Reflexology And Rehabilitation Medicine

摘　　要：目的 探讨胆囊结石患者腹腔镜与胆道镜联合保胆取石术后复发的高危因素。方法 选取2022年3月—2024年3月浠水县中医院收治的212例胆囊结石患者为研究对象,均行腹腔镜与胆道镜联合保胆取石术,根据术后随访复发情况将其分为复发组与未复发组。收集比较患者的年龄、性别、吸烟史、饮酒史、合并高血压、合并糖尿病、胆囊壁厚度、多发结石、饮食习惯、手术时间、术中出血量、胆囊收缩功能、结石残留、代谢异常等多方面基础资料。以单因素分析中相关因素为自变量并赋值,以术后复发情况作为因变量,进一步行多因素Logistic回归分析,获得影响胆囊结石患者术后复发的高危因素。结果 212例胆囊结石患者中,行腹腔镜与胆道镜联合保胆取石术后共有21例复发,复发率为9.91%(21/212)。单因素分析显示,两组多发结石、饮食习惯、胆囊结石家族史、胆囊收缩功能、结石残留、代谢异常比较,组间差异有统计学意义(P<0.05)。多因素分析显示,多发结石(OR=6.025,95%CI=1.953~18.589)、饮食习惯油腻(OR=4.132,95%CI=1.534~11.131)、有胆囊结石家族史(OR=8.721,95%CI=3.329~22.847)、胆囊收缩功能异常(OR=4.344,95%CI=1.703~11.082)、结石残留(OR=11.400,95%CI=4.276~30.392)、代谢异常(OR=5.765,95%CI=2.241~14.831)为影响胆囊结石患者术后复发的高危因素(P<0.05且OR>1)。结论 胆囊结石患者术后复发与多发结石、饮食习惯油腻、有胆囊结石家族史等有关,还需高度重视,做好术后的注意事项指导,尽可能降低复发风险。Objective Exploring the high risk factors for postoperative recurrence after laparoscopic and choledochoscopy combined with gallbladder-preserving lithotomy in patients with gallbladder stones.Methods A total of 212 patients with gallbladder stones admitted to Xishui County Hospital of Traditional Chinese Medicine from March 2022 to March 2024 were selected as the research objects,all patients underwent laparoscopic and choledochoscopy combined with gallbladde-preserving lithotomy.The patients were divided into recurrence group and non-recurrence group according to postoperative follow-up.The patients’age,gender,smoking history,drinking history,hypertension,diabetes,gallbladder wall thickness,multiple stones,dietary habits,operation time,intraoperative blood loss,gallbladder contraction function,residual stones,metabolic abnormalities and other basic data were collected and compared.Taking the relevant factors in univariate analysis as independent variables and assigning values,and postoperative recurrence situation as dependent variables,further multivariate Logistic regression analysis was performed to obtain the high risk factors affecting postoperative recurrence of patients with gallstones.Results Among the 212 patients with gallbladder stones,21 patients had recurrence after laparoscopic and choledochoscopy combined with gallbladder-preserving lithotomy,and the recurrence rate was 9.91%(21/212).Univariate analysis showed that there were significant differences between the two groups in multiple stones,dietary habits,family history of gallbladder stones,gallbladder contraction function,residual stones,and metabolic abnormalities(P<0.05).Multivariate analysis showed that multiple stones(OR=6.025,95%CI=1.953~18.589),greasy eating habits(OR=4.132,95%CI=1.534~11.131),family history of gallbladder stones(OR=8.721,95%CI=3.329~22.847),abnormal gallbladder contraction function(OR=4.344,95%CI=1.703~11.082),residual stones(OR=11.400,95%CI=4.276~30.392),abnormal metabolism(OR=5.765,95%CI=2.241~14.831)were high risk f

关 键 词：胆囊结石 腹腔镜 胆道镜 保胆取石术 术后复发 高危因素 

分 类 号：R657.4[医药卫生—外科学]