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[胆石症、胆囊胆固醇沉着症、黄色肉芽肿性胆囊炎:临床-形态学上的相似之处]

[Biliary calculosis, cholesterosis of the gallbladder, xanthogranulematous cholecystitis: clinical-morphological parallels].

作者信息

Shcherbinina M B, Zakrevskaia E V

出版信息

Ter Arkh. 2008;80(2):66-71.

Abstract

AIM

The retrospective analysis of prevalence, peculiarities of duration of biliary calculosis without gall bladder cholesterosis, biliary calculosis with gall-bladder cholesterosis and xanthogranulematous cholecystitis among persons who underwent cholecystectomy using clinical, instrumental and morphological data. MATERIAL AND METHODS. The data was evaluated obtained from medical cards of 4073 inpatients operated for cholelithiasis in 1999-2005. Preoperative clinical condition, body mass index, the results of abdominal ultrasonography, morphology of removed gall-bladders were evaluated. Statistical processing was made by Student's criterion and correlation analysis.

RESULTS

After cholecystectomy the diagnosis of cholelithiasis was confirmed in 4020 patients (98.7%). 1177 patients had concomitant gall-bladder cholesterosis (GBC), 38 patients-- xanthogranulematous cholecystitis (XC). GBC and XC were diagnosed morphologically only in the postoperative stage. The patients were divided into three groups: cholelithiasis without GBC (32 patients), cholelithiasis with GBC (68 patients), XC (38 patients). Diseases of the gall-bladder occur more frequent in women and older patients. XC in males occurred 2 times more frequently, cholelithiasis without cholesterosis and XC ran 2 times less. The above diseases are related with disorders of metabolism and lipid transport. GB dyskinesia has different causes in each of the diseases.

CONCLUSION

The analysis determined peculiarities of duration of cholelithiasis without gall-bladder cholesterosis, cholelithiasis with GBC and XC. This necessitate differential therapy.

摘要

目的

利用临床、仪器检查和形态学数据,对接受胆囊切除术的患者中无胆囊胆固醇沉着症的胆石症、伴有胆囊胆固醇沉着症的胆石症以及黄色肉芽肿性胆囊炎的患病率、病程特点进行回顾性分析。材料与方法。对1999 - 2005年因胆结石接受手术的4073例住院患者的病历数据进行评估。评估术前临床状况、体重指数、腹部超声检查结果、切除胆囊的形态。采用学生检验标准和相关分析进行统计处理。

结果

胆囊切除术后,4020例患者(98.7%)确诊为胆结石。1177例患者伴有胆囊胆固醇沉着症(GBC),38例患者患有黄色肉芽肿性胆囊炎(XC)。GBC和XC仅在术后阶段通过形态学诊断。患者分为三组:无GBC的胆石症(32例)、伴有GBC的胆石症(68例)、XC(38例)。胆囊疾病在女性和老年患者中更常见。男性患XC的频率是女性的2倍,无胆固醇沉着症的胆石症和XC的发病率则低2倍。上述疾病与代谢和脂质转运紊乱有关。每种疾病中胆囊运动障碍的原因各不相同。

结论

该分析确定了无胆囊胆固醇沉着症的胆石症、伴有GBC的胆石症和XC的病程特点。这需要进行差异化治疗。

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