胆囊结石合并胆囊癌134例临床分析

Clinical analysis of 134 case of gallbladder stones complicated with gallbladder carcinoma

目的探讨胆囊癌与胆囊结石的关系,为防治胆囊癌提供依据。方法应用病例对照研究,回顾性分析武警新疆维吾尔自治区总队医院2010年1月至2012年12月收治的胆囊结石合并胆囊癌患者134例(研究组)的临床资料,并随机抽取同期未合并胆囊癌的胆囊结石患者134例(对照组)为对照,比较两组患者的临床特征。结果研究组年龄为(60.5±11.7)岁,显著大于对照组的(49.6±10.3)岁,差异有统计学意义(t=7.916,P<0.05)。研究组、对照组胆囊结石病程分别为(9.3±4.1)年、(4.6±2.5)年,两组差异有统计学意义(t=11.682,P<0.01)。研究组多发结石、结石最大径、胆囊壁最大厚度分别为75例、(2.4±0.6)cm、(0.59±0.16)cm,对照组分别为46例、(1.3±0.5)cm、(0.87±0.23)cm,两组均差异有统计学意义(χ^2=3.978,t=6.217、5.110,均P<0.05)。研究组患者的胆囊炎、黄疸发生率均高于对照组,均差异有统计学意义(均P<0.05)。结论胆囊结石是胆囊癌致病因素之一,胆囊癌早期诊断困难,对年龄大、胆囊结石病程长、多发结石、结石直径大、胆囊壁厚的高危胆囊结石患者应积极进行手术干预。

Objective To investigate the relationship between gallbladder carcinoma and gallbladder stones,and provide theoretical basis for the prevention and treatment of gallbladder carcinoma.Methods A case-control study was used to retrospectively analyze the clinical data of 134 patients(study group)with gallbladder stones and gallbladder carcinoma treated in the Xinjiang Uygur Autonomous Region Corps Hospital of Chinese People′s Armed Police Forces from January 2010 to December 2012.Another 134 patients with gallbladder stones were selected as control group,and the clinical characteristics of the two groups were compared.Results The average age of patients in the study group was(60.5±11.7)years,which was significantly older than that in the control group[(49.6±10.3)years],the difference was statistically significant(t=7.916,P<0.05).The history of gallbladder stones in the study group and control group were(9.3±4.1)years and(4.6±2.5)years,respectively,and the difference between the two groups was statistically significant(t=11.682,P<0.01).The multiple stones,maximum stone diameter and maximum gallbladder wall thickness in the study group were 75 cases,(2.4±0.6)cm and(0.59±0.16)cm,respectively,which in the control group were 46 cases,(1.3±0.5)cm and(0.87±0.23)cm,respectively,the differences between the two groups were statistically significant(χ^2=3.978,t=6.217,5.110,all P<0.05).The incidences of cholecystitis and jaundice in the study group were higher than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Gallbladder stones are one of the causative factors of gallbladder carcinoma.Early diagnosis of gallbladder carcinoma is difficult.Patients with high-risk gallbladder stones who are old,have a long history of gallbladder stones,multiple stones,large stone diameters,and thick gallbladder walls should actively undergo surgical intervention.