新疆地区胆囊息肉样病变331例临床分析

摘要

Objective To explore the clinical characteristics and surgical indications of polypoid lesions of the gallbladder (PLG).Meth-ods The clinical data of 33 1 patients with PLG who underwent surgery in Department of General Surgery from August 2008 to December 2013 were analyzed retrospectively.Comparison of ratios between two groups was analyzed by chi -square test.Results Among the 331 surgical cases,there were 13 cases with adenomatous polyps (3.9%)and 318 cases with non-adenomatous polyps (96.1%).After com-paring the clinical characteristics of the two groups,significant differences were observed in the following parameters:sex (χ2 =6.2,P =0.013),age (≥40/<40)(χ2 =3.90,P =0.048),sizes of polyps (≥10 mm/<10 mm)(χ2 =77.4,P <0.000 1),number of le-sions (multiple/solitary)(χ2 =6.2,P =0.013),PLG basal width (≥6 mm/<6 mm)(χ2 =111.8,P<0.000 1),and presence or absence of concomitant calculi (χ2 =7.5,P =0.006).Conclusion Clinical symptom is considered an indication for surgery.For most of the gallbladder polyps,the risk of malignant transformation is extremely low.Other surgical indications for gallbladder excision include age≥40 years,single polyps measured ≥10 mm in diameter,polyp basal width ≥6 mm,recent rapid polyp growth,and tumor-associated factors such as polyps with calculi.%目的：对胆囊息肉样病变（PLG）的临床特征进行分析，并探讨手术切除指征。方法对2008年8月－2013年12月新疆医科大学第四附属医院331例住院已经手术的PLG患者资料进行回顾性分析。组间率的比较采用卡方检验。结果331例手术病例中，肿瘤性息肉13例（3．9％），非肿瘤性息肉318例（96．2％）；将肿瘤组与非肿瘤组的临床特征进行对比，发现性别（χ2＝6．2，P＝0．013）、年龄（≥40岁/＜40岁）（χ2＝3．90，P＝0．048）、息肉大小（≥10 mm/＜10 mm）（χ2＝77．4，P＜0．0001）、病灶数目（多发/单发）（χ2＝6．2，P＝0．013）、息肉基底宽度（≥6 mm/＜6 mm）（χ2＝111．8，P＜0．0001）、是否合并胆囊结石（χ2＝7．5，P＝0．006）在2组间分布差异具有统计学意义。结论症状是决定手术指征的一个单独因素，有症状即应手术。大多数胆囊息肉恶变率低，年龄≥40岁、直径≥10 mm的单发息肉、息肉基底宽≥6 mm、近期增大明显、息肉合并结石等肿瘤相关因素，也是胆囊切除的手术指征。