海南医科大学学报

目的:探讨慢性结石性胆囊炎胆囊切除术后腹泻(PCD)的危险原因。方法:选取本院收治的慢性结石性胆囊炎且行胆囊切除术患者120例,术前行胆囊脂肪餐试验,采用彩色多谱勒超声诊断仪测定胆囊收缩率,统计分析患者术后PCD发生情况,及年龄、胆囊收缩率与PCD发生的关系。结果:术后1月发生腹泻78例,3月发生腹泻48例,术后6月发生腹泻30例,发生率分别为65%、40%、25%;PCD发生与年龄分布呈负相关,即手术年龄越低,PCD发生率越高,差异有统计学意义(P<0.05);术前胆囊收缩率与PCD发生率呈正相关,即术前胆囊收缩率升高,PCD发生率及严重程度也随之升高,差异有统计学意义(P<0.05)。结论:PCD发生率随时间推移呈下降趋势,部分患者可在短期内自愈,部分可能迁延不愈。年龄、术前胆囊收缩率可做为PCD的预测指标,及个体化治疗的参考指标。

Objective:To investigate the risk reasons of posteholecysteetomy diarrhoea(PCD)in patients with chronic calculous cholecystitis.Methods:Selected 120 patients with chronic calculous cholecystitis that underwent cholecystectomyn in our hospital from.Gallbladder fat meal was tested preoperatively,using color doppler ultrasound to measure the gallbladder contraction ratio,and relationship between gallbladder contraction ratio and PCD and patients' age were analyzed.Results:Postoperative diarrhea was observed in 78 patients within one month,48 within three months,30 within six months,with rates of 65%,40% and 65% respectively;PCD is negatively correlated with the age distribution,the lower the age,the higher incidence of PCD.Preoperative gallbladder contraction is positively correlated to the incidence of PCD,the incidence of PCD and severity increase with the preoperative gallbladder contraction ratio increases.Conclusion:The incidence of PCD decreased,some patients can heal itself during a short period,but some may suffer from it for a long time.Age and preoperative gallbladder contraction ratio can be used as a predictor of PCD,and reference index for individualized therapy.