标题：胆肠吻合术后胆汁中与结石成因相关成分分析

      作者：陈超，朱朝庚，杨熙雯
    (湖南省人民医院肝胆外科，湖南 长沙 410005)

      卷次： 2016年27卷1期

      【摘要】 目的 探讨胆肠吻合术后胆汁成分的变化是否会导致术后患者结石的形成或复发。方法 收集
2014年6月至2015年2月期间我院肝胆科患者40例，其中行胆肠吻合术2~3个月后患者经“T”形引流管引出的胆
汁(观察组)和因“胆囊息肉”行腹腔镜下胆囊切除术患者胆总管内的胆汁(对照组)各 20例。对比两组胆汁中与
结石成因相关的成分，如总胆红素、直接胆红素、间接胆红素、总胆汁酸、钙离子和黏蛋白等。结果 观察组中
总胆红素、直接胆红素、间接胆红素、钙离子、黏蛋白测量数值均较对照组明显降低[(204.01±61.06) ?mol/L vs
(674.68±162.68) ?mol/L、(138.78±40.24) ?mol/L vs (441.13±94.30) ?mol/L、(65.23±21.22) ?mol/L vs (233.56±71.96) ?mol/L、
(0.80±0.23) mmol/L vs (1.98±0.64) mmol/L、(4.43±1.42) ?g/L vs (6.29±2.04) ?g/L]，而总胆汁酸测量值则较对照组明
显增高[(633.06±89.82) ?mol/L vs (474.89±75.21) ?mol/L]，差异均有统计学意义(P<0.05)。结论 胆肠吻合术后胆
汁成分的变化在短期内不会导致结石的形成或复发。

      【关键词】 胆肠吻合术；胆汁成分；结石；成因

      【中图分类号】 R656 【文献标识码】 A 【文章编号】 1003—6350（2016）01—0116—02


Analysis of the causes of the stone-formation after choledochojejunostomy.
CHEN Chao, ZHU Chao-geng.
Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Changsha 410005, Hunan, CHINA

【Abstract】 Objective To observe the changes of bile composition after choledochojejunostomy and explore
such change's contribution to stone-formation. Methods Altogether 40 patients in the Department of Hepatobiliary Sur-
gery in our hospital from Jun. 2014 to Feb. 2015 were recruited into this study, including 20 patients undergoing cholan-
gioenterostomy procedure with bile samples collected via T tube (study group) and 20 patients receiving laparoscopic
cholecystectomy for gallbladder polyps with bile samples collected via gallbladder cystic duct stump during operation
(control group). Data of stone-formation relevant factors, such as total bilirubin, direct bilirubin, indirect bilirubin, total
bile acid, calcium and mucin, were collected and compared between the two groups. Results In the study group, the
values of total bilirubin, direct bilirubin, indirect bilirubin, calcium, mucin were significantly lower than those in the con-
trol group[(674.68 ± 162.68) ?mol/L、(138.78 ± 40.24) ?mol/L vs (441.13 ± 94.30) ?mol/L、(65.23 ± 21.22) ?mol/L vs
(233.56±71.96) ?mol/L、(0.80±0.23) mmol/L vs (1.98±0.64) mmol/L、(4.43±1.42) ?g/L vs (6.29±2.04) ?g/L], while the
value of total bile acid in the study group was significantly higher [(633.06±89.82) ?mol/L vs (474.89±75.21) ?mol/L]
(P<0.05). Conclusion The changes of bile composition after cholangioenterostomy procedure probably do not contrib-
ute to the formation or recurrence of stones in the short term.

      【Key words】 Choledochojejunostomy; Bile composition; Stone; Formation
·临床经验·
6350.2016.01.039