胆总管小结石自发排石的临床相关特征因素分析

Cinical characteristics of small common bile duct stone′s spontaneous excretion

目的探讨胆囊结石合并胆总管小结石患者,胆总管小结石自发排石的概率和排石相关临床特征。方法回顾性分析216例患者临床资料,分析胆总管小结石自发排石的相关临床特征因素,单因素差异比较采用χ2检验、Pearson相关系数分析,多因素分析采用Logistic回归模型。结果单因素分析显示,临床上具备:年龄<50岁、女性、对症治疗3d腹痛快速缓解、肝功能3d快速恢复、胆总管内径正常或轻扩张、结石单发或多发位于一个部位、结石完全位于胆总管腔内或完全被括约肌包裹等特征的患者,更容易出现自发排石现象。多因素分析显示腹痛快速缓解、肝功能快速恢复、单发或多发一处结石是排石的独立特征因素。结论胆囊结石合并胆总管小结石患者,其胆总管结石有较高的自发排石概率。

Objective To investigate the excretion probability,clinical characteristics of gallstones with small common bile duct stone.Methods The clinical data of 216 patients were analyzed retrospectively.The relevant clinical characteristics of small common bile duct stone′s excretion were analyzed.χ2 and Pearson correlation coefficient were used to analyze correlation between small common bile duct stone′s excretion and relevant clinical characteristics,Multiple logistic regression analysis was performed to identify these excretion related factors.Results Univariate analysis showed that patients of age less than 50 years,female sex,abdominal pain relieved and liver function recovered rapidly in 3 days of treatment,normal or slightly dilated diameter of common bile duct,single or multiple stones located in one place,stones completely located in the common bile duct or completely within the sphincter were more likely to be discharged.Multivariate analysis indicated that rapid relief of abdominal pain,rapid recovery of liver function,single or multiple stones located in one place were independently correlated with small common bile duct stone′s excretion.Conclusion Small stones in common bile duct have a high probability of spontaneous removal in patients with gallstones and small common bile duct stone.