胆囊结石联合胆汁病理检查诊断华支睾吸虫感染

Diagnosis of Clonorchis sinensis infection in gallstone patients using a combined examination on gall.bladder stones and bile

目的探讨胆囊结石联合胆汁病理检查诊断胆囊结石患者合并华支睾吸虫感染的可行性．方法采用粪便直接涂片、胆汁离心镜检和胆囊结石病理切片镜检等方法．检查350例胆囊结石患者的粪便、胆汁和结石标本中的华支睾吸虫虫卵，分析3种方法的检出率。结果粪便直接涂片法、胆汁离心镜检和胆囊结石病理切片镜检华支睾吸虫虫卵的检出率分别为29．4％（103／350）、41．5％（145／350）和44．2％（155／350）。与胆汁离心镜检法相比，粪便直接涂片法检出率最低（X^2=11．05，P〈0．05），胆囊结石病理切片镜检的检出率差异无统计学意义（X^2=10．583，P〉0．05）。胆汁、胆石联合检出率为67．7％（237／350），明显高于其它方法（X^2=48．77，P〈0．05）。结论胆囊结石与胆汁联合病理检查虫卵可提高胆囊结石患者感染华支睾吸虫的诊断率。

Objective To investigate the value of the combined pathological examination on gallbladder stones and bile to diagnose Clonorchis sinensis infection in gallstone patients. Methods A total of 350 pa- tients with gallstones was enrolled in this study. Their stool, bile and gallbladder stones were collected to de- tect C. sinensis eggs using fecal direct smear, microscopical examination on bile centrifugal sediment and gall- stone slices respectively. The detection rate of above several methods was analyzed and compared. Results the detection rates of C. sinensis eggs using fecal direct smear, microscopical examination on bile centrifuga- tion sediment and gallstone slices were of 29.4%（103/350）, 41.5% （145/350） and 44.2% （155/350） respec- tively; The detection rate of feces direct smear was the lowest （X^2=11.05, P〈0.05）, while the rate of bile cen- trifugation microscopical examination had no difference with that of gallstone slices microscopical examination （X^2=0.583, P〉0.05）, but the rate of 67.7%（237/350） of the combined examination on gallstone slices and bile was significantly higher than that of the other methods（X^2=48.77, P〈0.05 ）. Conclusion The combined exam- ination on gallstone slices and bile for C. sinensis eggs detection can improve the diagnosis in gallstone pa- tients infected with C. sinensis infection.