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目的 研究胃切除术后胆囊收缩功能与胆结石发生率之间的关系。 方法 胃切除术后97例为观察组,另外86名健康人作对照组。在B超下测量空腹时胆囊截面积及脂餐1.5-2 h的面积。收缩功能分以下4种:良好:截面积>50％;欠佳:50％>缩小>30％;不良:缩小<30％;不收缩为无功能。 结果 观察组良好29例,欠佳和不良及无功能者计68例,占70.1％(68/97)。对照组良好69例,欠佳、不良17例,占19.8(17/86)。结石发生率,观察组32例,对照组4例,两组问统计学分析,收缩功能与结石发生率,P值均<0.01。 结论 胃切除术后,由于切断迷走神经肝胆支,胃肠重建,引起胆囊收缩素分泌减少等原因,致胆汁郁积,胆石发生率升高。
Objective To study the relationship between gallbladder contractility and the incidence of gallstones after gastrectomy. Methods After gastrectomy, 97 cases were treated as observation group and another 86 healthy people as control group. Measure the area of gallbladder cross-section and the area of 1.5-2 hour of fat meal in B-ultrasonography. Systolic function is divided into the following four kinds: Good: cross-sectional area> 50%; poor: 50%> reduced> 30%; bad: reduced <30%; Results The observation group was good in 29 cases, with 68 cases of poor and poor and no function, accounting for 70.1% (68/97). The control group, a good 69 cases, poor, 17 cases of poor, accounting for 19.8 (17/86). The incidence of stones, the observation group of 32 cases, 4 cases of control group, asked statistical analysis, systolic function and stone incidence, P value <0.01. Conclusions After gastrectomy, cholestasis and cholelithiasis are caused by cholestasis due to the cut off of hepatic and gallbladder branches of vagus nerve, gastrointestinal reconstruction, and the reduction of cholecystokinin secretion.