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[胆尿石症问题——它存在吗?]

[Problem of biliourolithiasis-does it exist?].

作者信息

Korita V R

机构信息

Department of Faculty Surgery, Medical Institute, Khabarovsk.

出版信息

Khirurgiia (Mosk). 1997(9):26-9.

PMID:9499130
Abstract

The analysis of 190 case records and 112 clinical cases of the patients with combination of biliary--and urolithiasis (biliourolithiasis-BUL) was carried out. Besides, for proving frequency of combined disease the differential analysis of 2300 case records of urolithiasis and biliary lithiasis separately was carried out as well. It was determined that this combination occurs in 10%. The purposeful, precise definition of complains, anamnesis of the illness, ultrasound and x-ray examination of biliary and urologic system are of paramount importance in timely diagnosis of such combined diseases. Diagnostic and tactic errors committed by surgeons as well as by urologists are often explained by insufficient knowledge of physicians about rather common combination of bilio- and urolithiasis. Among 112 patients 25 were admitted as urgent, the others--according to planned order--with various diagnoses, and their combined pathology was diagnosed at clinic only after purposeful precise examination. Urgent operations on biliary system were carried out in 21 patients. 84 patients underwent elective operations on biliary and urologic system, simultaneous operations of them being carried out in 31 patients. 7 patients due to their severe cardio-vascular disease underwent conservative treatment. Postoperative lethality made up 0.9%. From 190 patients (archives data) 162 have been operated on. Postoperative lethality made up 3.4%. Cost effect of simultaneous combined operations made up 1,168,000 roubles. It is advisable for patients with BUL diseases, taking into account function of the liver and kidney, their organs blood flow, to perform simultaneous of consecutive surgical interventions on biliary as well as on the urologic system which contribute to the well-timed social and professional rehabilitation of the patients.

摘要

对190例胆石症合并尿路结石(胆尿结石-BUL)患者的病例记录以及112例临床病例进行了分析。此外,为了证实合并疾病的发生率,还分别对2300例尿路结石和胆石症病例记录进行了差异分析。结果确定这种合并症的发生率为10%。对于此类合并疾病的及时诊断,有针对性地、准确地确定症状、病史,对胆道和泌尿系统进行超声及X线检查至关重要。外科医生和泌尿科医生所犯的诊断和策略性错误,往往是由于医生对相当常见的胆石症合并尿路结石缺乏足够的了解。在112例患者中,25例为急诊入院,其他患者按计划顺序入院,诊断为各种疾病,只有经过有针对性的精确检查后,才在临床诊断出其合并病理情况。21例患者接受了胆道系统急诊手术。84例患者接受了胆道和泌尿系统择期手术,其中31例进行了同期手术。7例患者由于严重心血管疾病接受了保守治疗。术后死亡率为0.9%。190例患者(档案数据)中有162例接受了手术。术后死亡率为3.4%。同期联合手术的成本效益为116.8万卢布。对于患有胆尿结石疾病的患者,考虑到肝脏和肾脏的功能、器官血流情况,对胆道和泌尿系统进行同期或连续的手术干预是可取的,这有助于患者及时实现社会和职业康复。

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