新疆地区胆囊息肉样病变331例临床分析

目的对胆囊息肉样病变(PLG)的临床特征进行分析,并探讨手术切除指征。方法对2008年8月-2013年12月新疆医科大学第四附属医院331例住院已经手术的PLG患者资料进行回顾性分析。组间率的比较采用卡方检验。结果 331例手术病例中,肿瘤性息肉13例(3.9%),非肿瘤性息肉318例(96.2%);将肿瘤组与非肿瘤组的临床特征进行对比,发现性别(χ2=6.2,P=0.013)、年龄(≥40岁/40岁)(χ2=3.90,P=0.048)、息肉大小(≥10 mm/10 mm)(χ2=77.4,P0.000 1)、病灶数目(多发/单发)(χ2=6.2,P=0.013)、息肉基底宽度(≥6 mm/6 mm)(χ2=111.8,P0.000 1)、是否合并胆囊结石(χ2=7.5,P=0.006)在2组间分布差异具有统计学意义。结论症状是决定手术指征的一个单独因素,有症状即应手术。大多数胆囊息肉恶变率低,年龄≥40岁、直径≥10 mm的单发息肉、息肉基底宽≥6 mm、近期增大明显、息肉合并结石等肿瘤相关因素,也是胆囊切除的手术指征。

Surgical indications of polypoid lesions of the gallbladder:a clinical analysis of 33 1 cases in Xinjiang Uygur Autono-mous Region,China

Objective To explore the clinical characteristics and surgical indications of polypoid lesions of the gallbladder （PLG）.Meth-ods The clinical data of 33 1 patients with PLG who underwent surgery in Department of General Surgery from August 2008 to December 2013 were analyzed retrospectively.Comparison of ratios between two groups was analyzed by chi -square test.Results Among the 331 surgical cases,there were 13 cases with adenomatous polyps （3.9%）and 318 cases with non-adenomatous polyps （96.1%）.After com-paring the clinical characteristics of the two groups,significant differences were observed in the following parameters：sex （χ^2 =6.2,P =0.013）,age （≥40/〈40）（χ^2 =3.90,P =0.048）,sizes of polyps （≥10 mm/〈10 mm）（χ^2 =77.4,P 〈0.000 1）,number of le-sions （multiple/solitary）（χ^2 =6.2,P =0.013）,PLG basal width （≥6 mm/〈6 mm）（χ^2 =111.8,P〈0.0001）,and presence or absence of concomitant calculi （χ^2 =7.5,P =0.006）.Conclusion Clinical symptom is considered an indication for surgery.For most of the gallbladder polyps,the risk of malignant transformation is extremely low.Other surgical indications for gallbladder excision include age≥40 years,single polyps measured ≥10 mm in diameter,polyp basal width ≥6 mm,recent rapid polyp growth,and tumor-associated factors such as polyps with calculi.