^99mTc-EHIDA SPECT 30 min胆囊显像对内镜微创保胆手术治疗胆石症的指导价值

Clinical value of ^99mTc-EHIDA SPECT 30 min gallbladder imaging for endoscopic minimally invasive cholecystolithotomy of cholelithiasis patients

目的探讨^99mTc-EHIDA SPECT 30 min胆囊显像对内镜微创保胆手术治疗胆石症的指导价值。方法回顾性分析因胆石症行胆囊~(99m)Tc-EHIDA SPECT显像的患者791例。其中,男388例,女403例,年龄(53.5±29.5)岁。对比分析~(99m)Tc-EHIDA SPECT 30 min胆囊显影结果与保胆治疗的情况。结果胆石症患者中,633例~(99m)Tc-EHIDA SPECT 30 min胆囊显影,提示胆囊管通畅,而158例患者~(99m)Tc-EHIDA SPECT 30 min胆囊未显影,提示胆囊功能异常。SPECT显示胆囊功能是否正常与保胆手术治疗胆石症之间的符合率为80.03%(633/791)。SPECT胆囊显影组与未显影组保胆率比较,差异有统计学意义(2=95.66,P=0.000),其优势比(OR)为7.91(95%CI:4.99~12.55)。结论~(99m)Tc-EHIDA SPECT 30 min胆囊显像是一种安全、快速、简便和非创伤性的检查方法,能够有效判断胆囊功能状态,对内镜微创保胆手术治疗胆石症有一定的指导作用。

Objective To investigate the value of surgical treatment guidance by 99mTc-EHIDA SPECT 30 min gallbladder imaging for endoscopic minimally invasive cholecystolithotomy of cholelithiasis patients.Methods 791 patients with cholelithiasis and 99mTc-EHIDA SPECT imaging were retrospectively analyzed,including 388 males and 403 females with an average age of(53.5±29.5)years.Comparative analysis of SPECT gallbladder imaging results and gallbladder surgical treatment.Results Of all the patients with confirmed cholelithiasis,633 case of 99mTc-EHIDA SPECT gallbladders were visualized,suggesting normal gallbladder function,while 158 cases of 99mTc-EHIDA SPECT gallbladder were not visualized,suggesting abnormal gallbladder function.The coincidence rate between SPECT gallbladder function and surgical gallbladder treatment was 80.03%(633/791).There was a significant difference between the gallbladder preservation rate of normal and abnormal gallbladder function groups(􀱽2=95.66,P=0.000),and the odds ratio(O^R)was 7.91 with 95%confidence interval 4.99~12.55.Conclusion 99mTc-EHIDA SPECT 30 min gallbladder imaging is a safe,rapid,simple and non-invasive method to effectively determine the functional status of gallbladder,to guide the decision of surgical treatment of cholelithiasis.