【摘要】 目的 探讨胆总管结石术后结石复发的影响因素。方法 回顾性分析2012年2月～2022年1月在我院住院的343例胆总管结石手术后21例胆总管结石复发的临床资料，将性别、年龄、民族、体重指数、总胆红素、直接胆红素、丙氨酸氨基转移酶、γ-谷氨酰转肽酶、术前血白细胞升高、术前胆道感染、第1次手术方式、手术时间、胆总管直径、胆总管结石数目和成分、合并症(胆囊结石、慢性支气管炎、2型糖尿病、原发性高血压)和肝病史等进行单因素分析，然后将P<0.05的变量进行logistic回归分析胆总管结石术后胆总管结石复发的影响因素。采用单因素和logistic回归分析胆总管结石术后复发的影响因素。结果 单因素分析显示性别、年龄、民族、体重指数、总胆红素、直接胆红素、丙氨酸氨基转移酶、γ-谷氨酰转肽酶、术前血白细升高、术前胆道感染、第1次手术方式、手术时间、合并慢性支气管炎和原发性高血压、肝病史差异无统计学意义(P>0.05)。多因素logistic回归分析显示2型糖尿病(OR=4.828,95%CI:1.644～14.178,P=0.004)、非胆固醇结石(OR=6.772,95%CI:2.386～19.222,P=0.000)和合并胆囊结石(OR=3.689,95%CI:1.159～11.739,P=0.027)是胆总管结石术后结石复发的影响因素。结论 2型糖尿病、胆总管结石成分为非胆固醇结石和合并胆囊结石是胆总管结石术后结石复发的影响因素。更多还原

【Abstract】 Objective To investigate the influencing factors of postoperative recurrence of common bile duct stones.Methods Clinical data of 21 cases of recurrent choledocholithiasis out of 343 cases of surgery for common bile duct stones from February 2012 to January 2022 admitted in our hospital were analyzed. Unifactorial analysis was conducted for gender, age, ethnicity, body mass index(BMI), total bilirubin, direct bilirubin, alanine aminotransferase, gamma-glutamyl transpeptidase, preoperative white blood cell elevation, preoperative biliary tract infection, first surgery method, operation time, diameter of common bile duct, number and composition of common bile duct stones, comorbidities(cholecystolithiasis, chronic bronchitis, type 2 diabetes mellitus, and primary hypertension), and history of liver disease. And then logistic regression analysis was conducted for variables with P<0.05 to analyze the influencing factors of recurrence of common bile duct stones after surgery. Results Unifactorial analysis showed no significant differences in gender, age, ethnicity, BMI, total bilirubin, direct bilirubin, alanine aminotransferase, gamma-glutamyl transpeptidase, preoperative elevated white blood cells, preoperative biliary tract infection, first surgery method, operation time, chronic bronchitis, primary hypertension, and history of liver disease(P>0.05). Multivariate logistic regression analysis showed that type 2 diabetes mellitus(OR=4.828,95% CI:1.644-14.178,P=0.004), non-cholesterol gallstones(OR=6.772,95% CI:2.386-19.222,P=0.000), and comorbidity of gallstones(OR=3.689,95% CI:1.159-11.739,P=0.027) were influencing factors of postoperative recurrence of common bile duct stones. Conclusion Postoperative recurrence of common bile duct stones is closely related to type 2 diabetes mellitus, non-cholesterol gallstones and comorbidity of gallstones.更多还原