胆囊息肉并发胆囊结石的术式选择疗效分析及相关因素影响

Analysis of the Curative Effect of Surgical Selection of Gallbladder Polyps Complicated with Gallbladder Stones and the Influence of Related Factors

目的探讨不同手术方式治疗胆囊息肉并发胆囊结石患者的临床疗效分析,以及对影响手术效果的相关因素进行探讨。方法选择该院2018年1月—2019年12月期间收治的80例胆囊息肉并发胆囊结石患者的临床资料进行回顾性分析和随访,按照手术方法的不同分为传统开腹手术组(n=31)与腹腔镜联合胆道镜手术组(n=49)。比较传统开腹手术组与腹腔镜联合胆道镜手术组治疗的总有效率,并探讨影响手术疗效的相关因素。结果传统开腹手术组患者的临床总有效率为83.87%,低于腹腔镜联合胆道镜手术组的临床总有效率(97.96%),组间差异有统计学意义(χ^(2)=5.432,P<0.05);单因素显示,患者的年龄、油腻饮食、结石直径、胆固醇息肉史与患者预后效果相关(P<0.05),但患者的手术方式、性别、饮酒与之不相关(P>0.05);多因素结果显示年龄>60岁、饮食最大直径≥1 cm饮食油腻者术以及以往有胆囊息肉家族史均为影响患者预后手术疗效的独立危险因素(P<0.05)。结论腹腔镜联合胆道镜手术治疗胆囊息肉并发胆囊结石的疗效优于单纯行传统开腹手术患者,尤其是年龄较大者、以往有胆固醇息肉史以及吸烟者。

Objective To investigate the clinical efficacy of different surgical methods for the treatment of gallbladder polyps complicated by gallbladder stones,and to explore the relevant factors that affect the surgical results.Methods The clinical data of 80 patients with gallbladder polyps and gallbladder stones who were admitted to the hospital from January 2018 to December 2019 were selected for retrospective analysis and follow-up.According to the different surgical methods,they were divided into the traditional open surgery group(n=31).Combined with laparoscopy and choledochoscopy group(n=49).Compare the total effective rate of the traditional laparotomy group and the laparoscopic combined choledochoscopy group,and explore the related factors that affect the efficacy of the operation.Results The total clinical effective rate of patients in the traditional open surgery group was 83.87%which was lower than that of the laparoscopic combined choledochoscopy group(97.96%),and the difference between the groups was statistically significant(χ^(2)=5.432,P<0.05);single factors showed that the patient's age,greasy diet,stone diameter,history of cholesterol polyps were related to the prognostic effect of the patient(P<0.05),but the patient's surgical method,gender,and alcohol consumption were not related to it(P>0.05);multivariate results It was shown that those who were older than 60 years old,had a greasy diet with a maximum diameter of≥1 cm,and had a family history of gallbladder polyps were independent risk factors that affected the prognosis of patients with surgery(P<0.05).Conclusion The curative effect of laparoscopic combined choledochoscopy in the treatment of gallbladder polyps complicated with gallbladder stones is better than that of patients undergoing traditional open surgery alone,especially those who are older,have a history of cholesterol polyps and smokers.