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目的 :探讨慢性单纯性胆囊炎并胆囊内结石对肝脏的影响。方法 :以慢性胆囊炎并胆囊内结石为观察组 (2 7例 ) ,胃十二指肠溃疡及外伤性脾破裂为对照组 (15例 )。两组术前均作各种常规及超声图像检查 ,尽可能排除该病以外因素对肝脏的影响。手术采取硬膜外麻醉 ,术中仔细探查 ,随机抽取 15例观察组胆囊胆汁行细菌培养 ,距胆囊底 7cm左右楔形切取肝组织作组织病理学检查。结果 :观察组均有间质性肝炎 ,以左叶明显 ;对照组仅 4例有轻微间质性肝炎。结论 :慢性单纯性胆囊炎并胆囊内结石可引起肝组织病理改变 ,其机理可能是基于胆汁成分异常改变及胆道动力学改变引起胆囊结石 ,在胆管炎及胆管周围炎的基础上 ,进一步损害肝脏
Objective: To investigate the chronic cholecystitis and gallbladder stones on the liver. Methods: Chronic cholecystitis and gallbladder stones were used as observation group (27 cases), gastroduodenal ulcer and traumatic rupture as control group (15 cases). The two groups were preoperative and routine ultrasound imaging, as far as possible exclude the factors outside the disease on the liver. Epidural anesthesia surgery, careful exploration during operation, randomly selected 15 cases of observation group gallbladder bile line bacterial culture, about 7cm from the end of the gallbladder wedge resection of liver tissue for histopathological examination. Results: All patients in the observation group had interstitial hepatitis with obvious left lobe. Only 4 patients in the control group had mild interstitial hepatitis. Conclusion: Chronic simple cholecystitis and gallbladder stones can cause pathological changes of liver tissue. The mechanism may be based on the abnormal changes of bile components and biliary tract dynamic changes caused by gallstones. On the basis of cholangitis and biliary peritonitis, further damage to the liver