99mTc-EHIDA SPECT 30 min胆囊显像对内镜微创保胆手术治疗胆石症的指导价值

Clinical value of 99mTc-EHIDA SPECT 30 min gallbladder imaging for endoscopic minimally invasive cholecystolithotomy of cholelithiasis patients

摘要:

目的 探讨^99mTc-EHIDA SPECT 30 min胆囊显像对内镜微创保胆手术治疗胆石症的指导价值。方法 回顾性分析因胆石症行胆囊^99mTc-EHIDA SPECT显像的患者791例。其中，男388例，女403例，年龄（53.5±29.5）岁。对比分析^99mTc-EHIDA SPECT 30 min胆囊显影结果与保胆治疗的情况。结果 胆石症患者中，633例^99mTc-EHIDA SPECT 30 min胆囊显影，提示胆囊管通畅，而158例患者^99mTc-EHIDA SPECT 30 min胆囊未显影，提示胆囊功能异常。SPECT显示胆囊功能是否正常与保胆手术治疗胆石症之间的符合率为80.03%（633/791）。SPECT胆囊显影组与未显影组保胆率比较，差异有统计学意义（??² = 95.66，P = 0.000），其优势比（O）为7.91（95%CI：4.99～12.55）。结论 ^99mTc-EHIDA SPECT 30 min胆囊显像是一种安全、快速、简便和非创伤性的检查方法，能够有效判断胆囊功能状态，对内镜微创保胆手术治疗胆石症有一定的指导作用。

Abstract:

Objective To investigate the value of surgical treatment guidance by ^99mTc-EHIDA SPECT 30 min gallbladder imaging for endoscopic minimally invasive cholecystolithotomy of cholelithiasis patients.Methods 791 patients with cholelithiasis and ^99mTc-EHIDA SPECT imaging were retrospectively analyzed, including 388 males and 403 females with an average age of (53.5 ± 29.5) years. Comparative analysis of SPECT gallbladder imaging results and gallbladder surgical treatment.Results Of all the patients with confirmed cholelithiasis, 633 case of ^99mTc-EHIDA SPECT gallbladders were visualized, suggesting normal gallbladder function, while 158 cases of ^99mTc-EHIDA SPECT gallbladder were not visualized, suggesting abnormal gallbladder function. The coincidence rate between SPECT gallbladder function and surgical gallbladder treatment was 80.03% (633/791). There was a significant difference between the gallbladder preservation rate of normal and abnormal gallbladder function groups (??² = 95.66, P = 0.000), and the odds ratio (O) was 7.91 with 95% confidence interval 4.99~12.55.Conclusion ^99mTc-EHIDA SPECT 30 min gallbladder imaging is a safe, rapid, simple and non-invasive method to effectively determine the functional status of gallbladder, to guide the decision of surgical treatment of cholelithiasis.