急性进展迅速型坏疽性胆囊炎的危险因素分析

目的 探讨急性进展迅速型坏疽性胆囊炎的危险因素.方法 回顾性分析同济大学附属同济医院肝胆外科2013年1 月至2019年12月收治的急性坏疽性胆囊炎病人临床资料,采用Logistic回归分析方法分析性别、年龄、高血压、糖尿病、最高体温、白细胞计数、C反应蛋白、墨菲征、胆囊周围积液、胆囊壁线性中断、胆囊结石颈部嵌顿与急性...

Analysis of risk factors of acute rapidly progressing gangrenous cholecystitis

Objective To explore the risk factors of acute rapidly progressing gangrenous cholecystitis.Methods Retrospective analysis was performed for clinical data of patients hospitalized with acute gangrenous cholecystitis from January 2013 to December 2019.Logistic regression analysis was utilized for analyzing gender,age,hypertension,diabetes mellitus and body temperature.The relationship between leukocyte count,C-reactive protein,Murphy sign,fluid accumulation around gallbladder,linear interruption of gallbladder wall,stone neck incarceration and acute progressive gangrene cholecystitis.Results Univariate regression analysis revealed that age≥60 years,diabetes mellitus,body temperature≥38℃,gallbladder wall thickening≥4 mm,linear interruption of gallbladder wall,stone incarceration in gallbladder neck,leucocyte≥15×109/L and C-reactive protein≥200 mg/L were risk factors of gangrenous gallbladders.Leucocyte count≥15×109/L,C-reactive protein≥200 mg/L,positive Murphy sign,linear interruption of gallbladder wall and stone neck incarceration were risk factors for acute rapidly progressing gangrenous cholecystitis.Multivariate regression analysis indicated that stone incarceration was an independent risk factor for cholecystitis indicator and there was acute rapid progression of gangrene.Conclusion As a critical and severe disease,acute progressing gangrenous cholecystitis is often mistaken for general cholecystitis and treatment is thus delayed.Clinicians should raise the awareness and early diagnosis and timely treatment are particularly important.Stone neck incarceration is an independent risk factor.