CAJ | 학술논문

目的探讨不同病因所致胆囊壁增厚的超声图像特征及其意义.方法选择2007年1月至2008年12月我院住院胆囊壁增厚患者127例,依据临床资料和部分术后病理结果分为:急性胆囊炎组33例,慢性胆囊炎组24例,心、肝、肾疾病组40例,其他原因组30例.选择2008年3月至12月我院88例无胆囊疾患史及其他能够引起胆囊壁增厚的健康体检者,按照是否禁食分为空腹对照组52例和餐后对照组36例.均测量比较其胆囊壁厚度并分析其声像图特征.结果空腹对照组胆囊壁厚(2.4±0.3)mm,餐后对照组(3.4±0.2)mm,急性胆囊炎组(5.6±0.4)mm,慢性胆囊炎组(4.2±0.3)mm,心、肝、肾疾病组(8.6±0.5)mm,其他原因组(3.4±0.3)mm.餐后对照组及各病变组胆囊壁厚与空腹对照组比较,差异均有统计学意义(P<0.05或P<0.01).慢性胆囊炎组与急性胆囊炎组及心、肝、肾疾病组比较,差异均有统计学意义(P<0.01);与其他原因组比较,差异无统计学意义(P>0.05).急性胆囊炎超声声像图以内膜改变为重,心、肝、肾疾病胆囊壁呈规则均匀的双边征,这与慢性胆囊炎引起的胆囊壁增厚较易鉴别.而其他原因组部分声像图特点与慢性胆囊炎有类似之处.结论胆囊壁增厚是一种非特异性病理表现,可由胆囊本身及胆囊外疾病引起.超声显示胆囊壁增厚时,应结合临床资料和声像图特点,鉴别引起胆囊壁增厚的原因.
목적 탐토불동병인소치담낭벽증후적초성도상특정급기의의.방법 선택2007년1월지2008년12월아원주원담낭벽증후환자127례,의거림상자료화부분술후병리결과분위:급성담낭염조33례,만성담낭염조24례,심、간、신질병조40례,기타원인조30례.선택2008년3월지12월아원88례무담낭질환사급기타능구인기담낭벽증후적건강체검자,안조시부금식분위공복대조조52례화찬후대조조36례.균측량비교기담낭벽후도병분석기성상도특정.결과 공복대조조담낭벽후(2.4±0.3)mm,찬후대조조(3.4±0.2)mm,급성담낭염조(5.6±0.4)mm,만성담낭염조(4.2±0.3)mm,심、간、신질병조(8.6±0.5)mm,기타원인조(3.4±0.3)mm.찬후대조조급각병변조담낭벽후여공복대조조비교,차이균유통계학의의(P<0.05혹P<0.01).만성담낭염조여급성담낭염조급심、간、신질병조비교,차이균유통계학의의(P<0.01);여기타원인조비교,차이무통계학의의(P>0.05).급성담낭염초성성상도이내막개변위중,심、간、신질병담낭벽정규칙균균적쌍변정,저여만성담낭염인기적담낭벽증후교역감별.이기타원인조부분성상도특점여만성담낭염유유사지처.결론 담낭벽증후시일충비특이성병리표현,가유담낭본신급담낭외질병인기.초성현시담낭벽증후시,응결합림상자료화성상도특점,감별인기담낭벽증후적원인.
Objective To study characteristics of ultrasonic scanning of thickened wall of the gall bladder by varied causes and their clinical significance. Methods Totally, 127 patients with thickened wall of the gall bladder were selected from the People's Hospital, Beijing University during January 2007 to December 2008, including 33 cases of acute cholecystitis, 24 cases of chronic cholecystitis, 40 cases of heart, liver and kidney diseases, and 30 cases with other diseases, according to their clinical data and surgically pathological examinations. Another 88 healthy persons who visited the hospital during March to December 2008 for regular physical checks-up, without history of gall bladder illness and other illness that could cause thickening of wall of the gall bladder, were selected as controls, including 52 fasting and 36 non-fasting controls. Thickness of wall of the gall bladder were measured for each of them, and characteristics of their ultrasonographs were analyzed. Results Thickness of wall of the gall bladder was (2.4 ±0.3) mm in fasting controls, statistically significant different from those of non-fasting controls [(3.4±0.2) mm], those with acute cholecystitis [(5.6 ±0.4) mm], those with chronic cholecystitis [ (4. 2±0. 3) mm], those with heart, liver and kidney diseases [ (8.6±0. 5) mm] , and those with other diseases [ ( 3. 4 ±0.3) mm] , respectively ( P < 0. 05 or P < 0. 01). There was statistically significant difference in thickness of wall of the gall bladder between those with chronic cholecystitis and those with acute cholecystitis, those with heart, liver and kidney diseases (P <0. 01) , but no significant difference in it was found between those with chronic cholecystitis and those with other diseases (P > 0.05 ) .Ultrasonographs showed more severe changes in the intima of wall of the gall bladder in those with acute cholecystitis and double layer thickened in those with heart, liver and kidney diseases, which could easily be differentiated from those of chronic cholecystitis with changes similar to those of other diseases with single layer hyper-echo of wall of the gall bladder. Conclusions Thickening of wall of the gall bladder is a non-specific pathological manifestation, which can be caused by changes in the gall bladder perse and illness other than it Thickening of wall of the gall bladder in ultrasonograph should be differentiated from that by other causes based on combination of their clinical data and ultrasonographic characteristics.