从青岛市立医院10年胆石症构成分析看胶东地区胆石症发病的变迁

Analysis of constitution of cholelithiasis in Qingdao Municipal Hospital： changes in occurrence of cholelithiasis in Jiaodong Region

目的 探讨山东省胶东地区近10年来（1998-2008年）胆石病构成及其变化情况.方法 采用回顾性调查的方法,收集青岛市立医院1998-2008年10年期间住院并经手术证实的2899例胆石病病人的临床资料,经计算机整理后用SPSS 12.0软件包进行统计分析,并将统计结果与1991年的资料进行比较分析.结果 胆石病的男女性别构成比2008年组与1991年组无统计学差异 但2008年组不同部位胆石病的男女比例明显不同,单纯胆囊结石、肝内胆管结石病人在性别上有统计学差异（P值均＜0.05）.单纯胆囊结石病发病的高峰年龄为40～69岁 胆囊合并胆总管结石以及单纯胆总管结石的发病高峰年龄均为70岁以上 肝内胆管结石的发病高峰年龄为40～59岁.结石部位之间比较,年龄分布差异有统计学意义（P值均＜0.01） 2008年组年龄分布与1991年组统计资料相比明显后移.单纯胆囊结石所占比例最多,其次是单纯胆总管结石.与1991年组相比,2008年组胆囊结石的构成比例显著升高 胆总管结石的构成比例下降 胆囊结石的比例随年龄增长而增加.胆囊合并胆总管结石和肝内胆管结石的构成比例与1991年组比较无差异.结论 山东省胶东地区近10年来（1998-2008年）胆石病构成及其变化情况与1991年的统计资料比较,女性单纯胆囊结石及肝内胆管结石构成比例要高于男性 老年胆石病人明显增加 胆囊结石的构成比例明显增高.

Objective To analyze the clinical features of patients with cholelithiasis treated in our hospital in the recent 10 years to explore the changing tendency of the spectrum of cholelithiasis in the Jiaodong region. Methods The clinical data of 2899 patients receiving operation for cholelithiasis in this hospital between January 1998 and January 2008 were retrospectively analyzed. The clinical parameters of sex, age and the lesion sites were reviewed. Compared with the clinical data of cholelithiasis patients in 1991, the data of the 2899 patients were statistically analyzed by SPSS 12.0 package.Results Significant differences existed in sex, e peak morbidity, and lesion sites. The ratio of male patients and female patients with cholelithiasis in differents site had obvious diversity. The constituent ratio of the female was manifestly higher than that of the male. The peak morbidity age range of cholecystolithiasis was 40 to 69. The peak age of gallbladder stones combined with common bile duct stones was 70 to 79, which was the same as that of common bile duct stones. The peak age of intrahepatic bile duct stones was 40 to 59. The constituent ratio of cholecystolithiasis was obviously higher than cholelithiasis in other sites. The incidence of cholecystolithiasis increased with age. Conclusion In the recent 10 years, female＇s ratio of gallbladder stones and intrahepatic stones was higher than male＇s.The morbidity of cholelithiasis significantly increased in aged patients. The spectrum of cholelithiasis has changed significantly.