摘要
目的 探讨超声监测下保胆取石术后胆囊结石复发的相关危险因素。方法 选取行微创保胆取石术的721例胆囊结石患者术前超声检查资料,观察指标:胆囊收缩功能,胆囊壁厚度,胆囊分隔,胆囊壁息肉结晶,结石数量、大小,是否存在结石嵌顿,术后随访3~48个月,分析影响患者术后结石复发的相关危险因素。结果 1)术后随访4年,失访113例,复发率为10.69%,第1~4年的非累计复发率分别为1.41%,2.18%,2.75%,3.62%;2)单因素分析结果显示,胆囊收缩功能、胆囊壁厚度、结石数量、结石大小及结石嵌顿对结石复发存在影响(均P <0.05);3)多因素logistic回归分析结果显示,胆囊收缩功能、胆囊壁厚度及结石嵌顿是影响胆囊结石复发的独立危险因素。结论 胆囊收缩功能不良、胆囊壁厚度≥3 mm、存在结石嵌顿是影响胆囊结石复发的重要危险因素,应对此类患者慎重实施保胆手术。
Objective To explore the risk factors of cholecystolithiasis recurrence after minimally invasive cholecystolithotomy with gallbladder conservation under ultrasonic monitor.Methods Preoperative data checked by ultrasonography of 721 cholecystolithiasis patients who underwent cholecystolithotomy in shandong provincial third hospital were collected to analyse the relevant risk factors of postoperative recurrent gallstone.Relevant clinical materials included function of gallbladder contraction,thickness of the gallbladder wall,separation of gallbladder,quantity and size of gallstone,etc.Postoperative follow-up ranged from 3 to 48 months.Results Quantity of people lost to follow-up was 113 and overall recurrent rate was 10.69%during follow-up.Non-accumulative recurrence rates of post-operation from 1 to 4 years were 1.41%,2.18%,2.75%,3.62%.Univariate analysis showed that function of gallbladder contraction,thickness of the gallbladder wall,gallstone incarceration and quantity as well as size of gallstone were of significance(P<0.05).Multivariate logistic regression analysis indicated the first three mentioned above were independent risk factors of recurrent cholecystolithiasis.Conclusion Gallbladder contraction,thickness of the gallbladder wall beyond 3 mm and gallstone incarceration are important risk factors for recurrent cholecystolithiasis.Therefore,preoperative accurate evaluation and operative selection of cholecystolithotomy with gallbladder conservation should be made cautiously.
作者
张晓彤
刘鸿玉
ZHANG Xiaotong;LIU Hongyu(Department of Ultrasound,Shandong Provincial Third Hospital,Jinan 250000,China)
出处
《医学影像学杂志》
2022年第10期1751-1754,共4页
Journal of Medical Imaging
关键词
胆囊结石
保胆取石术
超声检查
危险因素
Cholecystolithiasis
Cholecystolithotomy with gallbladder conservation
Ultrasonography
Risk factors
