胆囊结石与急性胰腺炎的关系

·论著·胆囊结石与急性胰腺炎的关系

陆斌罗和生

【摘要】目的探讨胆囊结石患者发生急性胰腺炎(AP)的影响因素。方法选取武汉大学人民

医院消化内科收治的诊断为胆囊结石的患者118例，通过影像学检查，测量胆囊大小、胆囊结石大小及

数量，判断是否伴有胆总管结石。根据有无并发AP进行分组，比较各相关因素对AP发生率的影响。

结果118例胆囊结石患者中并发AP61例。74例的胆囊大小正常，其中49例(66．2%)发生AP;44例

胆囊增大或缩小，其中12例(27．3%)发生AP。31例为单发结石，其中11例(35．5%)发生AP;87例为

多发结石，其中50例(57．5%)发生AP。发生AP的11例单发结石患者，其中8例(72．7%)结石≥10

mm;50例多发结石患者中41例(82．0%)结石＜10mm。19例伴有胆总管结石，其中17例(89．5%)发

生AP;99例无胆总管结石，其中44例(44．4%)发生AP。各因素的两组间差异均有统计学意义(χ2=

16．758，P=0．000;χ2=4．425，P=0．029;χ2=13．434，P=0．001;χ2=12．994，P=0．000)。结论急性

胆源性胰腺炎的发生与胆囊结石相关，胆囊是否正常、胆囊结石大小及数量、是否伴有胆总管结石均是

影响AP发生的相关因素。

【关键词】胰腺炎;胆囊结石病;胆囊;胆总管结石

Relationship between gallstones and acute pancreatitis Lu Bin，Luo Hesheng．Department of Gastroenterology，People's Hospital of Wuhan University，Wuhan430060，China

Corresponding author:Luo Hesheng，Email:xhnk@163．com

【Abstract】Objective To investigate the predictive factors of acute pancreatitis for patients with gallstone．Methods One hundred and eighteen patients with gallstones who were admitted to Department of Gastroenterology，People's Hospital of Wuhan University were selected，the gallbladder size，number and size

of gallstones，common bile duct stones were determined by imaging study．Then the patients were grouped

according to the complication of acute pancreatitis．Results Sixty-one cases of acute pancreatitis occurred out

of118patients．The gallbladder size of74patients was normal，and among them49(66．2%)developed acute

pancreatitis;the gallbladder size of44patients was increased or decreased，and among them12(27．3%)

developed AP．Thirty-one patients had a single gallstone，and11(35．5%)developed AP;while87patients

had multiple gallstones，and50(57．5%)was complicated with AP．Among patients with AP，11patients had

a single gallstone，and the size of the gallstone in the8patients(72．7%)was≥10mm;while50patients

had multiple gallstones，and the size of the gallstone in the41patients(82．0%)was＜10mm．Nineteen

patients were complicated with common bile duct stones，and17(89．5%)developed AP;while99patients

were not complicated with common bile duct stones，and44(44．4%)developed AP．The difference between

the two groups was statistically significant(χ2=16．758，P=0．000;χ2=4．425，P=0．029;χ2=13．434，

P=0．001;χ2=12．994，P=0．000)．Conclusions Acute biliary pancreatitis is associated with gallstones．

The size of gallbladder，size and number of gallstone，as well as the presence of common bile duct stones are

related to the development of AP．

【Key words】Pancreatitis;Cholecystolithiasis;Gallbladder;Choledocholithiasis

DOI:10．3760/cma．j．issn．1674-1935．2014．04．010

作者单位:430060湖北武汉，武汉大学人民医院消化内科

通信作者:罗和生，Email:xhnk@163．com