CAJ | 학술논문

目的探讨以胆囊排空障碍为特点的慢性非结石性胆囊炎的诊断方法与外科治疗.方法选取昆明医学院第二附属医院2006年1月至2008年12月收治的慢性非结石性胆囊炎42例临床资料进行分析.将其分为腹腔镜胆囊切除术组20例,非手术治疗组22例,比较其疗效.结果 42例均通过临床症状、B超、胆囊收缩功能检查、纤维胃镜、磁共振胰胆管成像得以诊断;均存在胆囊排空障碍,其中腹腔镜胆囊切除术组,术后随访18例,未再出现临床症状,失访2例;非手术治疗组,随访21例,临床症状反复发作19例,失访1例.腹腔镜胆囊切除术效果明显优于非手术治疗(P＜0.05).结论以胆囊排空障碍为特点的慢性非结石胆囊炎可以通过临床症状、胆囊收缩功能检查、MRCP得以诊断,治疗方法以腹腔镜胆囊切除术为佳.
목적 탐토이담낭배공장애위특점적만성비결석성담낭염적진단방법여외과치료.방법 선취곤명의학원제이부속의원2006년1월지2008년12월수치적만성비결석성담낭염42례림상자료진행분석.장기분위복강경담낭절제술조20례,비수술치료조22례,비교기료효.결과 42례균통과림상증상、B초、담낭수축공능검사、섬유위경、자공진이담관성상득이진단;균존재담낭배공장애,기중복강경담낭절제술조,술후수방18례,미재출현림상증상,실방2례;비수술치료조,수방21례,림상증상반복발작19례,실방1례.복강경담낭절제술효과명현우우비수술치료(P＜0.05).결론 이담낭배공장애위특점적만성비결석담낭염가이통과림상증상、담낭수축공능검사、MRCP득이진단,치료방법이복강경담낭절제술위가.
Objective To investigate the diagnosis and surgical treatment of chronic acalculous cholecystitis characterized by absence of gallbladder wall contractability. Methods The clinical data of 42 patients with chronic acalculous cholecystitis in our hospital from January 2006 to December 2008were analysed. The patients were grouped into two groups: laparoscopic cholecystectomy (LC) group in 20 and non-surgical group in 22. The patients' symptoms on follow-up in the two groups were compared. Results The 42 patients with chronic acalculous cholecystitis were diagnosed by symptoms,ultrasound, fatty meal gallbladder contractability studies under ultrasound, fiber optic gastroscopy and magnetic resonance cholangiopancreatography (MRCP). In all patients, there was a complete absence of gallbladder wall contractability. In the LC groups, 20 patients received LC. 18 patients were followed up, and there were no symptoms. Two patients were lost to follow up. In the non-surgical group, 22 patients received non-surgical treatment. In 21 patients who were followed up, 19 patients had symptoms. One patient was lost to follow up. There was a significant difference between the LC group and the non-surgical group (P＜0.05). Conclusions Chronic acalculous cholecystitis characterized by absence of gallbladder wall contractability could be diagnosed by symptoms, ultrasound, fatty meal gallbladder contractability studies under untrasound, and MRCP. The optimal treatment of chronic acalculous cholecystitis characterized by absence of gallbladder wall contractability is LC.