【摘要】 目的分析胆囊癌的临床特点,探讨早期诊断的相关指标,提高早期诊断率,最终达到改善预后。方法收集在河北医科大学第二医院治疗的胆囊癌患者80例,以胆囊结石及胆囊息肉患者90例作为对照,对2组进行组间比较及单、多因素Logistic回归分析。结果 2组间在患病年龄、腹胀纳差、胆囊占位、胆囊壁厚、肝门区肿大淋巴结、肝内外胆管扩张间存在差异;在实验室检查方面糖类抗原19-9(carbohydrate atigen 19-9,CA19-9)、糖类抗原125(carbohydrate atigen 125,CA125)、糖类抗原50(carbohydrate atigen 50,CA50)、血红蛋白(hemoglobin,HGB)、总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、间接胆红素(indirect bilirubin,IBIL)、丙氨酸转氨酶(alanine transaminase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、碱性磷酸酶(alkaline phosphate,ALP)、γ-谷氨酰转移酶(γ-glutamyl transpeptidase,γGGT)、总胆汁酸(total bile acid,TBA)存在差异。结论原发性胆囊癌的起病隐匿、临床表现无特异性,综合超声、CT、实验室检查可提高胆囊癌术前诊断率。控制胆囊癌的高危因素能有效预防胆囊癌的发生,从而改善预后。对于胆囊癌高危人群的早期筛查是胆囊癌临床治疗的关键。胆囊癌的临床分期对胆囊癌的预后影响大。提高胆囊癌早诊率是提高胆囊癌治疗水平的关键。更多还原

【Abstract】 Objective To increase the diagnosis and improve the prognosis of gallbladder carcinoma by analyzing the clinical characteristics and discussing the related indexes of early diagnosis. Methods Eighty cases of gallbladder carcinoma admitted in the Second Hospital of Hebei Medical University were involved.Ninety patients with gallstone or gallbladder polyps served as the control group, comparison was made between two groups,single and multiple logistic regression analysis were taken for analysis.Results There were significant differences in clinical condition(age,abdominal distension, anorexia),images(space occupying or thick wall of the gall bladder,enlarged lymph nodes in hepatic hila and dilation of bileduct) and laboratory indexes carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 125(CA125).carbohydrate antigen 50(CA50),hemoglobin(HGB).total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),alanine transaminase(ALT),aspartate aminotransferase(AST),alkaline phosphate(ALP),γ-glutamyl transpeptidase(γGGT).total bile acid(TBA) between two groups.Conclusion The onset of primary gallbladder carcinoma is slow and latent.There is no specific clinical appearance,while combining the ultrasound,CT images and laboratory tests could increase the pre-operative diagnosis effective prevention.The onset of gallbladder carcinoma expects effective prevention and improvement for the prognosis by controlling the high risk factors.Early screen the high risks is the key for treatment of gallbladder cancer.更多还原