超声胆囊收缩功能在保胆手术中的应用

Ultrasound Contractibility of Gallbladder Test for Preservation of Cholecyst

目的:探讨超声胆囊收缩功能在保胆手术中的应用价值。方法:2009年12月-2011年12月本院拟行保胆手术的胆囊结石及胆囊息肉样病变患者200例,其中男95例,女105例,超声测量术前及术后胆囊收缩率。结果:200例胆囊疾病患者中,胆囊结石56例,胆囊息肉样病变43例,胆囊结石合并息肉样病变101例。根据胆囊收缩率分为两组,收缩功能正常组(胆囊收缩率≥30%)和收缩功能减低组(胆囊收缩率<30%)。收缩功能正常组120例,收缩功能减低组80例。术前超声胆囊收缩功能正常的患者,均实行了保胆手术,术后复发率仅为2.5%。对术前胆囊收缩率低于30%的保胆术后患者,超声提示复发率明显高于胆囊收缩功能正常组,复发率达20%,两组比较差异有统计学意义(P<0.01)。胆囊结石的复发率高于胆囊息肉样病变患者,胆囊胆色素结石保胆手术后的复发率高于胆固醇结石的复发率。结论:超声胆囊收缩试验在保胆手术术式选择及术后恢复中有重要的临床应用价值。

Objective：To study the value of applying the ultrasound contractibility of gallbladder test in preservation of cholecyst. Method：200 cases of gallstones or polypoid lesions of gallbladder treated by preservation of cholecyst from December 2009 to December 2011 were analyzed.200 patients consisted of 95 males and 105 females.They were measured the contractibility of gallbladder by ultrasound befor or after the surgery.Result：Including 56 patients with gallstones,43 with polypoid lesions of gallbladder,101 with both gallstones and polypoid lesions of gall bladder.According to the contractibility of gallbladder,all the patients were divided into normal group（n=120） and decreased group（n=80）.The patients contractibility of gallbladder were above 30% befor surgery in normal group, and they were all treated by preservation of cholecyst,and the recurrence rate was 2.5%.The patients contractibility of gallbladder were below 30% in decreased group by preservation of cholecyst,the recurrence rate was obviously higher than the normal group（20% vs 2.5%,P0.01）.The recurrence rate in gallstones was higher than that in polypoid lesions of gallbladder,and the recurrence rate in dark bile pigment gallstone was higher than that in cholesterol gallstone.Conclusion：Ultrasound contractibility of gallbladder test is a effective method in treating gallbladder diseases,and it has a great significance clinical value in surgical selection and recovery after operation.