不同病因所致胆囊壁增厚的超声图像特征及其意义

Ultrasonographic features and clinical significance of gallbladder wall thickening caused by different causes

目的探讨不同病因所致胆囊壁增厚的超声图像特征及其临床意义。方法选择榆林市中医院2016年2月至2018年5月收治的胆囊壁增厚患者120例为观察组,同期健康体检人员120例为对照组,比较两组患者胆囊壁厚度与实验室检查结果,分析观察组患者胆囊疾病与非胆囊疾病导致胆囊壁增厚的原因。结果观察组患者胆囊壁厚度为(6.9±2.1) mm,血清总胆红素为(126.3±29.1)μmol/L,天冬氨酸转氨酶为(889±109) U/L,丙氨酸转氨酶为(1 076±651) U/L,均明显高于对照组的(2.1±1.1) mm、(50.1±23.1)μmol/L、(401±119) U/L、(544±209) U/L,差异均具有统计学意义(P<0.05);观察组患者中因胆囊疾病导致胆囊壁增厚者66例,其中慢性胆囊炎32例,胆囊腺肌增生症19例,厚壁型胆囊癌15例;非胆囊疾病患者54例,其中病毒性肝炎15例,肝硬化13例,慢性心力衰竭7例,慢性肾炎5例,低蛋白血症14例。胆囊疾病组与非胆囊疾病组患者胆囊壁厚度比较,差异均具有统计学意义(P<0.05)。结论超声声像学特征对胆囊性疾病与非胆囊性疾病导致的胆囊壁增厚的鉴别具有重要临床价值,综合分析患者的临床症状与实验室检查结果可做出更加准确的诊断提示,提高诊断准确率。

Objective To discuss the ultrasonographic features and the clinical significance of gallbladder wall thickening caused by different causes. Methods During February 2016 and May 2018, 120 patients with gallbladder wall thickening admitted to Yulin Hospital of Traditional Chinese Medicine were selected as observation group, and 120 healthy people who underwent health examinations during the same period were used as control group. The thickness of gallbladder wall and the results of laboratory examination were compared between the two groups. Then the reasons for gallbladder wall thickening caused by gallbladder diseases and non-gallbladder diseases were analyzed in the observation group. Results In the observation group, the thickness of the gallbladder wall, the serum total bilirubin, the aspartate aminotransferase, and the alanine aminotransferase were(6.9±2.1) mm,(126.3±29.1)μmol/L,(889±109) U/L,(1 076±651) U/L, significantly higher than corresponding(2.1±1.1) mm,(50.1±23.1)μmol/L,(401±119) U/L, and(544±209) U/L in the control group(P<0.05). In the observation group, 66 patients had gallbladder wall thickening due to gallbladder disease, including 32 cases of chronic cholecystitis, 19 cases of gallbladder adenomyosis, and 15 cases of thick-walled gallbladder cancer;54 patients were caused by non-gallbladder diseases, including 15 cases of viral hepatitis, 13 cases of cirrhosis, 7 cases of chronic heart failure, 5 cases of chronic nephritis, and 14 cases of hypoproteinemia.There was significant difference in the thickness of gallbladder wall between the gallbladder disease group(n=66) and the non-gallbladder disease group(n=54), P<0.05. Conclusion Ultrasonographic features have important clinical value in the differential diagnosis of gallbladder wall thickening caused by gallbladder disease and non-gallbladder disease.Comprehensive analysis of the patient’s clinical symptoms and laboratory results can make more accurate diagnostic tips and improve diagnostic accuracy.