胆囊壁间结石研究

Research report on intramural gallstones

目的探讨胆囊壁间结石与胆囊腔内结石的关系。方法对2009年2月至2009年8月我院普外科实施内镜保胆取石手术的116例胆囊腔内结石合并胆囊壁间结石患者的结石标本与同期171例单纯胆囊腔内结石标本进行对照研究，分析其临床特点并用FT—IR光谱分析和磨碎镜检的方法分析结石。结果116例胆囊腔内结石与胆囊壁间结石结石类型符合率为97．4％，均以胆色素性结石和混合性结石为主。结石磨碎镜检结果显示，116例胆囊腔内结石与胆囊壁间结石中华支睾吸虫卵检出的符合率为98．3％，且胆色素性结石与混合性结石明显高于胆固醇性结石。116例合并胆囊壁间结石的腔内结石标本与171例单纯腔内结石标本结石类型比较结果显示，前者胆色素性结石的比例高于后者，而华支睾吸虫卵检出率两组差异无统计学意义（P〉0．05）。结论胆囊壁间结石主要是胆色素性或混合性结石。胆囊壁间结石与胆囊腔内结石具有同源性。

Objective To investigate the relationship between intramural gallstones and intraluminal gallstones. Methods In this present study, the control study was applied to analysis on the gallstones from 116 cholecystolithiasis patients with intramural gallstones as well as intraluminai gall stones. All the patients were from the general surgery department and accepted gallbladder-preserving cholecystolithotomy during 2009.02-- 2009.08. Meanwhile, 171 patients with intraluminal gallstones were investigated the clinical traits; and gallstones from them were analyzed with FT-IR and microsopic examination. Results The results showed the coincidence rate of stone type was 97.4%, and it was mainly pigment gallstones and mixed gallstones in 116 cases; the coincident detection rate of clonorchis sinensis eggs was 98.3%, and it was much higher in the pigment gallstones and mixed gallstones than that in the cholesterol gallstones. The ratio of pigment gallstones from the 116 patients group was higher than the 171 patients group, and the detection rate of C. sinensis eggs of the two groups had no statistical difference （P〉0.05）. Conclusions The stone type of intramural gallstones was mainly pigment gallstones and mixed gallstones. Intramural gallstones and intraluminal gallstones were homologous.