腹痛发作特征与胆囊切除术后患者临床健康状况改善的关系

Relationship between the characteristics of abdominal pain episodes and the improvement of clinical health status in patients after cholecystectomy

目的:探讨腹痛发作特征与胆囊切除术后患者临床健康状况改善的关系。方法:选择2010-01-2015-12来我院接受胆囊切除术的胆囊结石患者82例,临床医生应根据病历信息及临床检查详细记录患者的年龄、性别、烟酒嗜好,高血压、高血脂、高血糖史和现状,询问并记录患者术前每周腹痛发作次数、持续时间最长的腹痛发作时间等信息。利用患者入院时及术后3个月胃肠道生活质量指数(GIQLI)的提高程度表示患者临床健康状况改善程度;利用视觉模拟评分法(VAS)表示患者疼痛发作强度。应用单因素、多因素非条件Logistic回归分析影响胆囊切除术患者临床健康状况改善的危险因素。结果:82例胆囊切除术患者中有20例患者术后GIQLI评分提高程度<5分,62例患者术后GIQLI评分提高程度≥5分。影响胆囊切除术患者临床健康状况改善的单因素、多因素Logistic回归分析结果显示,基线GIQLI评分≤105.5分是影响胆囊切除术患者临床健康状况改善的危险性因素(P<0.05),基线GIQLI评分≤105.5分不利于胆囊切除术患者术后临床健康状况改善。疼痛发作特征(每周腹痛发作次数、持续时间最长的腹痛发作时间、疼痛发作的最大强度)、基础疾病(高血压、高血脂、高血糖史)与胆囊切除术患者临床健康状况改善无关。结论:腹痛发作特征、基础疾病不能反映胆囊切除术后患者临床健康状况改善情况,胆囊切除术的时机应根据其他临床特征进行。

Objective：To investigate the relationship between the characteristics of abdominal pain and the improvement of clinical health status after choleeystectomy. Method： Eighty-two patients with cholecystolithiasis in our hospital accept cholecystectomy from Jan 2008 to Dec 2015 were selected as study subjects. Clinicians should follow the details of medical records and clinical examinations record the patient＇s age, gender, alcohol and tobacco addiction, hypertension,hyperlipidemia, hyperglycemia and the current situation. Information about the number of episodes of abdominal pain, duration, longest abdominal pain, and duration of attack before and after the operation was asked and recorded. The improvement of the gastrointestinal quality of life index （GIQLI） at the time of admission and the 3 months after operation indicated the improvement of the patient＇s health status~ Visual analogue scale （VAS） was used to indicate the intensity of the patient＇s pain attack. Univariate and multivariate uncondition- al Logistic regression analysis were used to analyze the risk factors of the improvement of clinical health status in patients undergoing cholecystectomy. Result：Eighty-two cases of patients with cholecystectomy in 20 cases of patients with postoperative improve the degree of GIQLI score〈5points, 62 cases of patients with postoperative GIQLI score increased≥Spoints. Univariate and multivariate Logistic regression analysis showed that the improvement of clinical health status in patients with cholecystectomy,the baseline GIQLI score ≤105.5 was a risk factor for the improvement of clinical health status in patients undergoing choleeystectomy （P〈0.05）, the baseline GIQ- LI score ≤105.5 was not conducive to the improvement of the clinical health status of the patients after cholecystectomy. The characteristics of pain episodes （weekly abdominal pain, number of episodes, duration, longest duration of abdominal pain, maximum intensity of pain episodes） and underlying diseases （hypertension, hyperlipidemia,hyperglycemia） were not related to the improvement of clinical health in patients undergoing cholecystectomy. Conclusion：Characteristics of abdominal pain episodes and underlying diseases cannot be used to inform patients with symptomatic cholecystolithiasiswho are skeptic about the timing of cholecystectomy for optimal benefit Timing of cholecystectomy should therefore be basedon other characteristics.