胆石症危险参数的临床价值

The clinical significance of risk factors for cholelithiasis.

作者对我院２０年来１８６９例胆石症手术治疗结果进行了回顾分析，归纳出影响手术预后的８项危险参数和３个危险级别。８项危险参数；（１）年龄＞６０岁；（２）白细胞＞２０×１０９／Ｌ；（３）血清胆红质＞１７１μｍｏｌ／Ｌ；（４）血球比积＜３０％，（５）血清白蛋白＜３０ｇ／Ｌ；（６）血肌酐＞１１５μｍｏｌ／Ｌ；（７）复杂类型的胆石症；（８）有重要脏器功能损害。３个危险级别：Ⅰ级：共１５９６例，包括１～３项危险参数，无死亡；Ⅱ级：包括４～６项危险参数，２４５例中７例死亡；Ⅲ级：包括７～８项危险参数，３２例均死亡，死亡率１００．０％。我们认为这种分类方法对术前评估患者预后及治疗具有指导意义。

Abstract After the surgical therapeutic results of 1869 cases with cholelithiasis during the past 2 decades were retrospectively analysed, a serial of prognostic related factors including 8 risk parameters and 3 risk grades were inducted. The 8 risk parameters were: age>60 years old; WBC >20 × 109/L; Serum bilirubin >171 μmol/L; Hemotocrit <30%; Serum albumin<30gm/L ; Serum creatinine>115μmol /L ; gallstones with various complications and functional damage of vital organ. While the 3 risk grades were designated according to the number of the risks parameters composed as grade Ⅰ (1￣3) ;Ⅱ4￣6)and Ⅲ (7￣8) respectively. A total of 1592 cases was in grade Ⅰ , 245 cases in grade Ⅱ with mortality of 3.3% and 32 cases in grade Ⅲ with mortality of 100%. This classification was shown to be of great valuc in prognostic eveluation