分析并总结胆囊结石合并胆囊癌患者的临床特点及有效治疗手段

Analyze and Summarize the Clinical Features and Effective Methods of Cholecystolithiasis Complicated with Gallbladder Carcinoma

目的探究胆囊结石合并胆囊癌患者的临床特点及治疗有效手段,为临床实践提供理论依据。方法选取2017年2月至2018年1月中国人民解放军海军陆战队医院收治的胆囊结石合并胆囊癌患者50例为研究组,选取同期胆囊结石患者50例为对照组。分析两组患者一般资料,探究胆囊结石合并胆囊癌患者的有效治疗方案。结果研究组患者黄疸发生率、胆囊炎发生率明显高于对照组,差异有统计学意义(P<0.05),研究组胆石症病程长于对照组,差异有统计学意义(P<0.05),研究组体质量下降、腹痛发病率与对照组比较,差异无统计学意义(P>0.05)。研究组患者病理分型:19例(38.00%)浸润型腺癌;12例(24.00%)乳头状腺癌;10例(20.00%)硬化型腺癌;6例(12.00%)鳞状细胞癌;3例(6.00%)黏液型腺癌。研究组患者36例(72.00%)实施根治性切除手术治疗;14例(28.00%)实施姑息性手术治疗。随访研究组患者2年,存活35例(70.00%);死亡15例(30.00%)。结论胆囊结石为胆囊癌的一个致病因素,需重视胆囊癌的筛查,特别是40岁以上者,实施CT诊断,避免出现漏诊,导致病程延长,影响疾病的治疗。

Objective To explore the clinical characteristics and effective means of patients with gallstone and gallbladder cancer,and to provide theoretical basis for clinical practice.Methods From February 2017 to January 2018,50 patients with gallstone combined with gallbladder cancer in Marine Corps Hospital of the Chinese People's Liberation Army were selected as the study group,and 50 patients with gallstone in the same period were selected as the reference group.The general data of the two groups were analyzed and compared,and the effective treatment scheme for patients with gallstone and gallbladder cancer was explored.Results The incidence rate of jaundice and cholecystitis in the study group were significantly higher than that in the reference group,with statistical difference(P<0.05).The duration of cholelithiasis in the study group was longer than that in the reference group(P<0.05).The difference in body mass and abdominal pain between the study group and the reference group was not statistically significant(P>0.05).Pathological classification of patients in the study group:19 cases(38.00%)of invasive adenocarcinoma;12 cases(24.00%)of papillary adenocarcinoma;10 cases(20.00%)of sclerosing adenocarcinoma;6 cases(12.00%)of squamous cell carcinoma;3 cases(6.00%)of mucinous adenocarcinoma.36 patients(72.00%)received radical resection;14 patients(28.00%)received palliative surgery.All patients were followed up for 2 years,35 cases(70.00%)survived and 15 cases(30.00%)died.Conclusion Cholecystolithiasis is a pathogenic factor of gallbladder cancer.It is necessary to pay attention to the screening of patients with gallbladder cancer,especially for those over 40 years old.CT diagnosis should be carried out to avoid missed diagnosis,prolong the course of disease and affect the treatment of the disease.