胃切除术后胆囊收缩功能与胆结石发生率的观察

Survey of the relation between gallbladder contractive function and stone formation after gastrectomy by ultrasonography

目的 研究胃切除术后胆囊收缩功能与胆结石发生率之间的关系。 方法 胃切除术后97例为观察组,另外86名健康人作对照组。在B超下测量空腹时胆囊截面积及脂餐1.5-2 h的面积。收缩功能分以下4种:良好:截面积>50％;欠佳:50％>缩小>30％;不良:缩小<30％;不收缩为无功能。 结果 观察组良好29例,欠佳和不良及无功能者计68例,占70.1％(68/97)。对照组良好69例,欠佳、不良17例,占19.8(17/86)。结石发生率,观察组32例,对照组4例,两组问统计学分析,收缩功能与结石发生率,P值均<0.01。 结论 胃切除术后,由于切断迷走神经肝胆支,胃肠重建,引起胆囊收缩素分泌减少等原因,致胆汁郁积,胆石发生率升高。

AIM To survey the relation between gallbladder contractive function and stone formation in gastrectomized patients.METHODS B type ultrasonography was undertaken to measure gallbladder area at fasting and 1.5-2 hours after fatty meal. In 97 gastrec-tomized(survey group), and 86 healthy persons(control group) gallbladder contractive functions were as follows: good, area decreased> 50%; poor, 50% >area decreased>36% ; poorer, <30%; and no contract. RESULTS In the survey group, good contraction were in 29 patients, poor, poorer and no contract in 68 (70.1%, 68/97), with stone formation in 32, but in control group, good in 69, both poor and poorer in 17 (19.8%, 17/86), with stone in 4(both P<0.01)CONCLUSION Because of liver rami of vagus nerve resected, gallbladder contraction and secretion decreased, and bile stasis, gall stone will develop easily in gastrectomized patients.