新疆汉族、维吾尔族患者保胆取石术后结石复发的危险因素分析

目的探讨新疆地区保胆取石术后维吾尔族与汉族胆囊结石复发的危险因素。 方法对2010年1月至2015年1月期间在新疆军区总医院行微创保胆术治疗的5 126例维吾尔族、汉族患者进行出院后结石复发随访,每年一次,连续随访满3年,随访截止时间2018年1月。对胆囊结石复发患者进行流行病学调查并填报流行病学量表《新疆维吾尔自治区胆囊疾病危险因素调查表》,未复发的维吾尔族、汉族保胆术后患者各随机抽取100 例作为对照进行流行病学分析。采用单因素方差分析及Logistic回归分析影响术后结石复发的危险因素。 结果术后随访满3年患者共4 654例,共有320例患者胆囊结石复发（复发率6.9%）,其中3 066例汉族患者中胆囊结石复发171例（5.6%）,1 588例维吾尔族患者中胆囊结石复发149例（9.%）,维吾尔族患者保胆取石术后胆囊结石复发率高于汉族患者,差异有统计学意义（χ²=17.64,P<0.01）。回收有效调查问卷288份（90.0%）。Logistic回归分析显示父母胆石症家族史、术后胆囊排空功能是汉族和维吾尔族保胆取石术后胆囊结石复发的共同危险因素,体质量指数、牛羊肉饮食是维吾尔族患者胆囊结石复发的特有危险因素（均P<0.05）。 结论新疆地区保胆取石术后维吾尔族胆囊结石复发率高于汉族患者,复发率高的原因可能与肥胖、牛羊肉饮食有关。胆结石家族史、术后胆囊排空功能是胆囊结石复发的主要危险因素。

Risk factors for postoperative stone recurrence after cholecystolithotomy in Xinjiang Han nationalityand Uygur nationality patients

ObjectiveTo discuss the risk factors of cholecystolithiasis recurrence for Han nationality and Uygur nationality patients who underwent minimally invasive gallbladder-preserving surgery. MethodsFive thousand one hundred and twenty-six Han and Uygur patients who underwent minimally invasive gallbladder-preserving surgery in the General Hospital of Xinjiang Military Command from January 2010 to January 2015 were followed up once a year consecutively for 3 years, and the follow-up deadline was January 2018. The patients with gallstone recurrence were requested to fill out the epidemiological scale "Investigation table of risk factors for gallbladder diseases in Xinjiang Uygur Autonomous Region" and epidemiological investigation were conducted. One hundred patients without recurrence after gallbladder-preserving surgery for Han or Uygur were randomly selected as control to undergo epedemiologicial investigation. One-way ANVOA and Logistic regression analysis statistical methods were used. ResultsA total of 4 654 patients were followed up for 3 years and 320 patients had recurrence of gallstones (recurrence rate was 6.9%). Of the 3 066 Han patients, 171 (5.6%) had recurrence of gallstones; and of the 1 588 Uygur patients, 149 (9.4%) had recurrence of gallstones, the recurrence rate was significantly higher in Uygur patients than that of Han patients (χ²=17.64, P<0.01). Logistic regression analysis indicated that the family history of parental cholelithiasis and postoperative gallbladder emptying function were common risk factors for recurrence of gallbladder stones after gallbladder-preserving surgery in Han and Uygur patients; body mass index and mutton diet were unique risk factors of recurrence of gallstones in Uygur patients. ConclusionsThe recurrence rate of gallstones after gallbladder-preserving surgery is higher in Uygur patients than that of Han nationality in Xinjiang. The possible reasons for the high recurrence rate may be related to obesity and mutton diet. Parental cholelithiasis family history and postoperative gallbladder emptying function are still the main risk factors for recurrence of gallbladder stones.