56例慢性胆囊炎临床分析

Chronic Cholecystitis:Clinical Analysis of 56 Cases

目的探讨慢性胆囊炎的误诊及治疗情况,分析误诊原因,提高诊治水平。方法对有误诊经历的56例慢性胆囊炎的临床资料进行分析。结果 56例中慢性结石性胆囊炎22例,慢性非结石性胆囊炎34例;误诊为慢性胃炎32例,消化性溃疡12例,病毒性肝炎5例,心绞痛3例,带状疱疹后遗症1例,胃肠神经官能症3例。35例行手术治疗,21例保守治疗,均取得较好效果。结论有误诊经历的慢性胆囊炎中以误诊为"慢性胃炎"或"消化性溃疡"最多,因此有消化道症状的患者均应早期行腹部B超检查了解胆囊情况,并作胃镜、十二指肠钡餐等排除胃、十二指肠疾病,必要时行胆囊造影,以免误诊误治。治疗仍以手术治疗为主,也可采取保守治疗。

Objective To discuss the misdiagnosis and treatment of chronic eholecystitis, analyze the cause of misdiagnosis and improve its diagnosis and treatment. Methods An analysis was made of the clinical data of 56 cases of misdiagnosis of chronic cholecystitis. Results Among 56 cases, there were 22 cases of chronic calculous cholecystitis and 34 cases of chronic acalculous cholecystitis. And 32 cases were misdiagnosed as chronic gastritis, 12 cases as peptic ulcers,5 cases as viral hepatitis,3 eases as cardiac angina, 1 case as sequelae of perpes zoster and 3 cases as gastrointestinal neurosis. And surgical therapy was used for 35 cases and conservative therapy for 21 cases,with good treatment effects. Conclusion Most of the misdiagnosis cases of chronic cholecystitis were considered as chronic gastritis or peptic ulcers. Therefore, the patients with gastrointestinal symptoms need to undergo abdominal type-B ultrasound examination in the early period so as to understand the situation of the gallbladder, and meanwhile the examination of gastroscope or hypotonic duodenal barium will be added to exclude gastric or duodenal diseases. Gallbladder imaging is carried out when necessary to avoid misdiagnosis. The main treatment is surgery and conservative treatment is secondary.