期刊文献+

微创保胆治疗1008例胆囊息肉的临床及病理分析 被引量:1

Clinical and pathological analysis of 1008 patients with gallbladder polyps treated by minimally invasive gallbladder-preserving surgery
收藏 分享 导出
摘要 目的 分析采用微创保胆治疗的胆囊息肉患者的临床病理特点以及探讨 0~4 ℃ 冰盐水加去甲肾上腺素冲洗胆囊黏膜的止血效果。 方法 回顾性分析 2009 年 1 月至 2016 年 12 月期间在新疆军区总医院行微创保胆治疗的 1 008 例胆囊息肉患者的临床资料,分析胆囊息肉的临床病理学类型,比较 0~4 ℃ 冰盐水加不同浓度(0、16、24、30 mg/L)去甲肾上腺素冲洗胆囊黏膜的止血效果(以冲洗胆囊黏膜时间反映止血效果),同时分析手术时间与胆囊息肉复发的关系。 结果 本研究中 1 008 例胆囊息肉患者成功行保胆手术 1 000 例,有 8 例为肿瘤性息肉立即行胆囊切除术。单发息肉 128 例,多发息肉 880 例。息肉直径 5~10 mm 者 910 例,10~15 mm 者 98 例。1 008 例胆囊息肉的术后病理分析结果为胆固醇息肉 912(90.5%)例、炎性息肉 74(7.3%)例、腺肌增生 14(1.4%)例,肿瘤性息肉 8(0.8%)例 [腺瘤 6 例,腺癌(T0N0M0)2 例]。随访 1~8 年(平均 4 年),胆囊息肉复发 30(3.0%)例,均为多发、胆固醇息肉。有 125、230、555 及 98 例患者分别采用 0、16、24、30 mg/L 浓度的去甲肾上腺素加上 0~4 ℃ 冰盐水冲洗胆囊黏膜的时间分别为(44±5)min、(33±6)min、(17±5)min 及(17±4)min,除 24 mg/L 浓度组与 30 mg/L 浓度组间的冲洗胆囊黏膜时间比较差异无统计学意义(P〉0.05)外,其余各浓度组间的冲洗胆囊黏膜时间两两比较差异均有统计学意义(P〈0.05)。970 例胆囊息肉未复发者的手术时间与 30 例胆囊息肉复发者比较差异无统计学意义 [(60±19)min 比(62±21)min,P〉0.05]。 结论 胆囊息肉的病理类型以胆固醇息肉为主,炎性息肉及肿瘤性息肉较少,以多发为主;用 0~4 ℃ 冰盐水加不同浓度去甲肾上腺素对胆囊黏膜出血有一定的止血效果,以 24 mg/L 浓度冲洗胆囊� Objective To analyze clinicopathologic characteristics of 1 008 patients with gallbladder polyps by minimally invasive gallbladder-preserving surgery, and to explore hemostatic effect of 0-4 ℃ cold saline plus different concentrations norepinephrines in flushing gallbladder mucosa bleeding. Methods The clinical data of 1 008 patients with gallbladder polyps by the minimally invasive gallbladder-preserving surgery from 2009 to 2016 in the General Hospital of Xinjiang Military Command were retrospectively analyzed. The clinicopathologic types of gallbladder polyps and the relationship between the operation time and the recurrence of gallbladder polyps were analyzed, the hemostatic effects of 0-4 ℃ cold saline plus different concentrations (0, 16, 24, and 30 mg/L) norepinephrines in flushing gallbladder mucosa bleeding (The hemostatic effect was reflected by the time of flushing gallbladder mucosa bleeding) were compared. Results One thousand patients with non-tumorous gallbladder polyps successfully underwent the minimally invasive gallbladder-preserving surgery, another 8 cases patients with tumorous gallbladder polyps underwent the cholecystectomy immediately. There were 128 cases of single polyps and 880 cases of multiple polyps. The polyp diameters of 910 cases were 5-10 mm and 98 cases were 10-15 mm. The pathological analysis indicated that there were 912 (90.5%) cases of the cholesterol polyps, 74 (7.3%) cases of the inflammatory polyps, 14 (1.4%) cases of the adenoid hyperplasia, and 8 (0.8%) cases of the neoplastic polyps [adenoma 6 cases, adenocarcinoma (T0N0M0) 2 cases]. The gallbladder polyps recurrences were found in 30 (3.0%) cases during 1-8 years of follow-up (average 4 years), all of them were the multiple and cholesterol polyps. The flushing gallbladder mucosa bleeding time of 0-4 ℃ cold saline plus 0, 16, 24, and 30 mg/L concentraions norepinephrine was (44±5) min, (33±6) min, (17±5) min, and (17±4) min in the 125, 230, 555, and 98 pati
作者 王红伟 刘江伟 康燕 林海 张嘉慧 李骜 沈才福 高伟 郑文建 李廷军 杨帆 WANG Hongwei1,2, LIU Jiangwei2, KANG Yan3, LIN Hal2, ZHANG Jiahui1, LI Ao1, SHEN Caifu2, GAO Wei2, ZHENG Wenjian2, LI Tingjun2, YANG Fan2 (1. Medical College of Shihezi University, Shihezi, Xinjiang 832000, P. R. China; 2. Department of Hepatobiliary Surgery, General Hospital of Xinjiang Military Command, Urumqi 830000, P. R. China; 3. Department of Ultrasonography, The No.69240 Army Hospital, Urumqi 830000, P. R. China)
出处 《中国普外基础与临床杂志》 CAS 2018年第9期1065-1070,共6页 Chinese Journal of Bases and Clinics In General Surgery
基金 新疆维吾尔族自治区科技计划项目(项目编号:201042145) 军队临床高新技术重大项目(项目编号:2010gxjs016)
关键词 胆囊息肉 微创保胆术 去甲肾上腺素 止血 复发 gallbladder polyp minimally invasive gallbladder-preserving surgery norepinephrine hemostasis recurrence
作者简介 通信作者:刘江伟,Email:ljw273273@163.com
  • 相关文献

参考文献25

二级参考文献148

共引文献120

同被引文献19

引证文献1

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈