胆红素正常与胆红素增高的结石性胆囊炎临床治疗对比分析.docVIP

精品论文 参考文献 胆红素正常与胆红素增高的结石性胆囊炎临床治疗对比分析 德阳市人民医院肝胆外科 618000 【摘 要】目的 探讨胆红素正常与胆红素增高的结石性胆囊炎行单纯胆囊切除术的安全性和有效性。方法 收集我院2013.6-2014.6合并血清总胆红素增高在51.3 umol/L以下的结石性胆囊炎病例，与胆红素正常的病例进行回顾性对比，分析两组间术中及术后胆总管结石的发现率，并比较其差别。结果 胆红素增高组术中及术后无1例发现继发性胆总管结石，胆红素正常组腹腔镜胆囊切除术后1例发现继发性胆总管结石，经二次行胆道探查取石后治愈。两组间胆总管结石发现率无统计学差异。结论 胆红素轻度增高（低于51.3 umol/L）的结石性胆囊炎病人，经过术前B超或MRCP证实无胆总管结石，行单纯胆囊切除术是安全的和可取的。 【关键词】结石性胆囊炎，胆红素增高 The clinical analysis of calculous cholecystitis with normal and elevated serous bilirubin level Abstract Object To analyze the validity and effectiveness of cholecystectomy in cases of calculous cholecystitis with normal and elevated serous bilirubin level. Method Patients during 2013.6 to 2014.6 with normal and elevated serous bilirubin level were collected and divided into two groups：test group with elevated serous bilirubin level and control group with normal level. The occurrence of choledocholithiasis during and after operation was compared between two groups. Result There was no case of choledocholithiasis in test group，and 1 case in control group which was cured by a second operation. There was no statistical difference between two groups. Conclusion It is valid and effective to carry out sole cholecystectomy in patients of calculous cholecystitis with lightly elevated serous bilirubin level（lt;51.3 umol/L），after exclusion of choledocholithiasis by B-ultrasound or MRCP preoperatively. Key words Calculous cholecystitis，elevated serous bilirubin 【中图分类号】R735.8【文献标志码】A【文章编号】2096-0867（2016）-06-339-01 随着国人生活水平的提高，结石性胆囊炎成为我国最常见的胆石症类型。部分结石性胆囊炎合并有血清胆红素的增高，为诊断是否有继发胆总管结石以及手术方式的选择增加了困难。本文选择我院2013.6-2014.6合并血清总胆红素增高在51.3 umol/L以下的结石性胆囊炎病例，与胆红素正常的病例进行回顾性对比分析，结果如下： 1 资料与方法 1.1 临床资料 合并血清总胆红素增高但在51.3 umol/L以下的结石性胆囊炎病例43例为实验组，胆红素正常的结石性胆囊炎病例49例为对照组，两组年龄29-67岁，平均年龄48.5岁，男性38例，女性54例，均无伴随其他疾病。两组间性别和年龄无统计学差别。 1.2 胆红素水平 我院血清总胆红素水平正常值参考范围为5.0-28.0 umol/L，实验组胆红素水平高于28.0 umol/L，但低于51.3 umol/L，对照组胆红素水平在参考值内，两组间胆红素水平（以均数plusmn;标准差X(—)plusmn;s表示）见表1。