Khan Muhammad Laiq-uz-Zaman, Abbassi Mujeeb Rehman, Jawed Muhammad, Shaikh Ubedullah
J Pak Med Assoc. 2014 Feb;64(2):159-62.
To underline the status of male gender and gall bladder wall thickness as significant risk factors for acute cholecystitis complications.
The retrospective study, with purposive sampling of the patients of acute cholecystits in age above 18 years, who were operated within 10 days of onset of symptoms, was conducted at the Department of Surgery, Dow University Hospital, Karachi, by reviewing the patients' medical record from March 2010 to August 2012. Correlation of incidence of acute cholecystitis complications (empyema and gangrene) to male gender and to the sonographic gall bladder wall thickness more than 4.5 mm was analysed using SPSS 16.
Out of 62 patients, 8 (13%) patients had gangrene while 10 (16.12%) had empyema. Overall, there were 21 (33.87%) males in the study. Ten (47.6%) of the male patients developed empyema or gangrene of the gall bladder as a complication of acute cholecystitis. Of the 41 (66.12%) female patients, only 8 (19.5%) developed these complications. There were 22 (35.48%) cases of gall bladders with sonographic wall thickness more than 4.5 mm who were operated for acute cholecystitis. Of them, 16 (72.7%) had empyema or gangrene.
Male gender and sonographic gall bladder wall thickness more than 4.5 mm were statistically significant risk factors for suspicion of complicated acute cholecystitis (empyema/gangrene) and by using these risk factors, we can prioritise patients for surgery in the emergency room.
强调男性性别和胆囊壁厚度作为急性胆囊炎并发症重要危险因素的地位。
在卡拉奇道氏大学医院外科进行了一项回顾性研究，采用目的抽样法选取年龄在18岁以上、症状发作后10天内接受手术的急性胆囊炎患者，回顾2010年3月至2012年8月期间患者的病历。使用SPSS 16分析急性胆囊炎并发症（积脓和坏疽）的发生率与男性性别以及超声检查胆囊壁厚度超过4.5毫米之间的相关性。
62例患者中，8例（13%）发生坏疽，10例（16.12%）发生积脓。总体而言，研究中有21例（33.87%）男性。10例（47.6%）男性患者发生胆囊积脓或坏疽，作为急性胆囊炎的并发症。在41例（66.12%）女性患者中，只有8例（19.5%）发生这些并发症。有22例（35.48%）超声检查胆囊壁厚度超过4.5毫米的病例因急性胆囊炎接受手术。其中，16例（72.7%）发生积脓或坏疽。
男性性别和超声检查胆囊壁厚度超过4.5毫米是怀疑复杂性急性胆囊炎（积脓/坏疽）的统计学显著危险因素，通过使用这些危险因素，我们可以在急诊室对患者进行手术优先级排序。
