胆总管结石多次复发的危险因素分析

Analysis of the risk factors of multiple recurrent common bile duct stones

目的探讨胆总管结石多次复发的危险因素。方法收集2010年1月-2015年12月该院消化内科收治的复发性胆总管结石患者73例,将首次取石术后结石复发≥2次的17例患者作为多次复发组,其余为单次复发组。采用t检验、χ~2检验对比两组患者的临床资料,对相关因素行Logistic回归分析,分析多次复发的危险因素。结果对比分析显示,多次复发组与单次复发组胆总管直径、胆囊切除术史、胆总管夹角<45°的发生率比较,差异有统计学意义[(1.66±0.66)和(1.31±0.30)cm、94.1%(16/17)和62.5%(35/56)、23.5%(4/17)和1.8%(1/56),均P<0.05]。Logistic回归分析显示,相对于单次复发患者,胆囊切除史(OR=31.319,95%CI:1.71~573.58,P=0.020)、胆总管夹角<45°(OR=22.722,95%CI:1.54~335.70,P=0.023)为结石多次复发的独立危险因素。结论胆囊切除史、胆总管夹角<45°为结石多次复发的独立危险因素。

Objective To investigate the risk factors of multiple recurrence of common bile duct(CBD)stones.Methods From January 2010 to December 2015,73 patients who recurred one or more times of CBD stones were collected.17 patients who recurred≥twice were regarded as multiple recurrence group,with the others as single recurrence group.The clinical data of the two groups were compared by t test or Chi‐square test.The factors were analyzed with multivariate Logistic regression analysis to find out the risk factors of multiple recurrence.Results The comparative analysis between the two groups showed that diameter of CBD[(1.66±0.66)vs(1.31±0.30)cm],history of cholecystectomy[94.1%(16/17)vs 62.5%(35/56)]and the angle of bile duct less than 45°[23.5%(4/17)vs 1.8%(1/56)]were statistically significant(P<0.05).Relative to single recurrence group,Logistic regression analysis indicated that history of cholecystectomy(OR=31.319,95%CI:1.71~573.58,P=0.020)and the angle of bile duct less than 45°(OR=22.722,95%CI:1.54~335.70,P=0.023)were independent risk factors of multiple recurrence.Conclusion History of cholecystectomy and the angle of bile duct less than 45°are independent risk factors of multiple recurrence of CBD stones.