Osipenko M F, Litvinova N V, Voloshina N B, Frolov Ia A
Klin Med (Mosk). 2013;91(5):49-52.
The aim of the work was to analyse dynamics of gastrointestinal symptoms and risk factors at different periods after cholecystectomy (CCE) in patients with cholelithiasis (CL). It was a prospective open cohort observational study with interviewing the patients before, 6 and 36 months after cholecystectomy for the treatment of CL. The pain symptom of CL persisted in 65.9% of the patients till the 6th month after CCE and in 57.3% of the patients till the 36th month. The logistic univariant analysis showed high probability of persistence and/or appearance of biliary pain within 6 months after surgery in patients suffering biliary colic before it (OR = 5.3, p = 0.01) and having hereditary aggravation of CL (OR = 2.7, p = 0.38). The relationship between biliary pain and planned surgical intervention for the treatment of CL was documented 3 years after the operation (OR = 2.6, p = 0.018). Similar relationship was revealed after 6 and 36 months (OR = 3.8, p = 0.002). Biliary pain within 6 months after CL was an independent prognostic factor of its development within the next 3 years. Other increasingly severe gastrointestinal symptoms were heartburn, intolerance of greasy food, and disturbed intestinal passage as a result of biliary insufficiency or disordered intestinal motility. The above relationships between gastrointestinal symptoms may be used to predict their appearance within 6 months after CL.
这项研究的目的是分析胆结石（CL）患者胆囊切除术后（CCE）不同时期胃肠道症状的动态变化及危险因素。这是一项前瞻性开放队列观察性研究，在胆囊切除术前、术后6个月和36个月对CL患者进行访谈。CL的疼痛症状在65.9%的患者中持续到CCE后第6个月，在57.3%的患者中持续到第36个月。单因素逻辑分析显示，术前患有胆绞痛（OR = 5.3，p = 0.01）及CL有遗传加重因素（OR = 2.7，p = 0.38）的患者在术后6个月内持续和/或出现胆绞痛的可能性较高。术后3年记录到胆绞痛与计划中的CL手术治疗之间的关系（OR = 2.6，p = 0.018）。在术后6个月和36个月后也发现了类似的关系（OR = 3.8，p = 0.002）。CL术后6个月内的胆绞痛是其在接下来3年内发生的独立预后因素。其他日益严重的胃肠道症状包括烧心、不耐油腻食物以及由于胆汁不足或肠道蠕动紊乱导致的肠道排便障碍。上述胃肠道症状之间的关系可用于预测CL术后6个月内这些症状的出现。
