摘要
目的:明确肝囊型包虫病与胆囊疾病之间有无相关性,分析两者之间可能的相关性因素。方法:收治肝囊型包虫病患者307例,对临床资料进行回顾性分析,按标准排除97例,对210例初次手术治疗肝囊型包虫病患者胆囊并发症临床资料进行分析。行二元多因素Logistic回归分析可能的影响因素。结果:需要手术治疗的胆囊并发症的发生率58.1%(122/210)。行二元多因素Logistic回归分析显示,肝内包虫病灶最大病灶单径大小(P=0.02)、病灶总径(P=0.000229)、病灶位于肝内位置(P=0.00000726)及肝内病灶数目(P=0.05)是初次手术治疗肝囊型包虫病患者胆囊并发症发生的重要相关因素(P≤0.05),此外患者的性别、年龄、临床症状、肝囊型包虫病病灶的分型及腹腔粘连状况与患者胆囊并发症发生的相关程度差别无统计学意义(P>0.05)。结论:①肝内包虫病灶最大单径直径、肝囊型包虫病病灶总径和病灶位于肝内位置,肝脏内病灶数目是初次手术治疗肝囊型包虫病患者其胆囊并发症发生的重要相关因。②肝内最大包虫囊肿及全部病灶总经越大,肝囊型包虫病患者其胆囊病变的发生概率越高。③包虫病灶位于肝脏Ⅰ段、Ⅳ段、Ⅴ段、Ⅷ段,较病灶位于其他肝段,患者胆囊病变的发生概率高。④多发包虫病灶较单发病灶,其胆囊并发症的发生概率高。
Objective ： Analysis of primary hepatic cystic echinococcosis （HCE） patients with gallbladder complications related fac- tors. Methods： Retrospective analysis from January 2001 to December 2011 to our hos- pital treatment of hepatobiliary hydatid Sec- tion 307 cases of hydatid patients, according to exclude exclusion criteria in 97 cases, 210 cases of primary operation in treatment of hepatic cystic echinococcosis gallbladder complications in patients with clinical data analysis. Multivariate Binary Logistic regres- sion analysis of possible factors. Results： Need operation treatment of gallbladder the incidence of complications was 58. 1% （122/210）. Multivariate Binary Logistic re- gression analysis showed that：Liver hydatid lesions in the largest single diameter diame- ter（P = 0.02）, the total diameter lesions （ P -- 0. 000229）, lesions located in intrahepat- ic position （ P = 0. 00000726 ） and the num- ber of intrahepatic lesions （ P = 0.05 ） is the primary surgical treatment of liver capsule type hydatid disease patient gallbladder complications of the important relevant fac- tom （ P 〈 0.05 ） ; however, Patients age, gen- der, clinical symptoms, liver capsule type echinococcosis lesions parting and celiac ad- hesion conditions and patient gallbladder complications related degree difference was statistically significant （ P 〉 0.05 ）. Conclu- sion： （~）Hepatic hydatid lesions maximum single diameter, lesion size, lesion located in total intrahepatic location and intrahepatic lesions is the number of initial operation in treatment of hepatic cystic echinococcosis patients with gallbladder complications asso- ciated with important. Hepatic hydatid cyst and all lesions maximum total by the larger,hepatic cystic echinococcosis patients the gallbladder lesions occur with high prob- ability. Liver hydatid lesions located in section I , IV, V, Vl segment segment seg- ment, a lesion located in the other patients with gallbladder diseases liver segment, the probability of the occurrence Of high. Mul- tiple hydatid lesions with single lesions, the gallbladder complications with high proba-bility.
