保胆术后胆囊结石复发的危险因素分析

摘要

Objective To analyze the risk factors of recurrence of gallstone after gallbladder-preserving surgery.Methods The clinical data of patients who underwent gallbladder-preserving cholecystolithotomy in our hospital between January 2011 and January 2013 and were followed up for 3 years was retrospectively analyzed,28 patients with gallstone recurrence as observation group,and 40 patients without gallstone recurrence as control group.The univariate regression analysis was performed with x 2 test,then Logistic univariate regression analysis was performed to analyze the risk factors of recurrence.Results The rates of age ≥60 years old,family history of gallstone,poor gallbladder function,too thick gallbladder wall,the number of gallstones ≥10,greasy diet,lack of exercise in observation group (67.86％,35.71％,57.14％,64.29％,53.57％,57.14％,64.29％) were significantly higher than those in control group (32.50％,7.50％,27.50％,22.50％,27.50％,20.00％,30.00％)(P＜0.05).Logistic regression analysis showed that age,family history of gallstone,poor gallbladder function,too thick gallbladder wall,the number of gallstones,greasy diet,and lack of exercise were the risk factors of gallstone recurrence in patients after gallbladder-preserving surgery (P＜0.05).Conclusions Advanced age,family history of gallstone,poor gallbladder function,too thick gallbladder wall,a large number of gallstones,greasy diet,and lack of exercise are risk factors of gallstone recurrence in patients after gallbladder-preserving surgery.Surgical indications should be chosen appropriately,and patients undergoing gallbladder-preserving surgery should have light diet and proper exercise to reduce the recurrence rate of gallstone.%目的 分析保胆术后胆囊结石复发的危险因素.方法 回顾性分析2011年1月至2013年1月在本院接受保胆取石术后随访满3年的患者的临床资料,随机抽取28例胆囊结石复发患者设置为观察组,并随机抽取40例未复发病例为对照组,对两组患者先行x2检验进行单因素分析,再行Logistic单因素回归分析,判断导致患者复发的危险因素.结果 观察组67.86％的患者年龄≥60岁,较对照组的32.50％显著较高(P＜0.05);观察组胆囊结石家族史、胆囊功能差、胆囊壁过厚、结石数量≥10枚、饮食油腻、运动缺乏患者的概率分别为35.71％、57.14％、64.29％、53.57％、57.14％、64.29％,较对照组的7.50％、27.50％、22.50％、27.50％、20.00％、30.00％显著较高(P＜0.05);根据Logistic回归分析显示年龄、胆囊结石家族史、胆囊功能差、胆囊壁过厚、结石数量、饮食油腻、运动缺乏是导致胆囊结石患者保胆术后胆囊结石复发的危险因素(P＜0.05).结论 年龄偏大、有胆囊结石家族史、胆囊功能差、胆囊壁过厚、结石数量多、饮食油腻、缺乏运动的患者在行保胆术后更易复发结石,临床上应合理选择手术适应症;行保胆取石术的患者应清淡饮食、适当运动,以降低结石复发率.