| Objective: The purpose of this study is to explore the diagnostic value of Roman IV standard in Chinese patients with biliary pain.To understand the risk factors of functional gallbladder disease(FGBD)and provide guidance for the treatment mode of FGBD.Method: 1.Total 454 patients with upper abdominal pain were selected from the Second People’s Hospital of Wuhu City,and preliminary screening was conducted according to whether they met the diagnostic criteria of Roman IV standard biliary pain,and the number of patients who met the criteria was recorded.2.The patients(n=289)who were diagnosed as biliary diseases and planned to undergo laparoscopic cholecystectomy(LC)were investigated with questionnaires to collect and record the symptoms and characteristics,concomitant diseases,lifestyle and other information of the patients,and regular telephone follow-up was conducted to collect and record the changes of symptoms after LC.3.After sorting out the questionnaire,a total of 248 patients met the requirements.Those patients were grouped in two ways:(i)According to whether the patients met the Rome IV standard diagnostic criteria for biliary pain,the patients were divided into typical symptom group and atypical symptom group(ii)The patients were divided into FGBD group and organic disease group according to whether they were definitely diagnosed as organic disease by further auxiliary examination,and SPSS 26.0 was usedfor statistical analysis.Result: 1.The sensitivity,specificity,underdiagnosis,misdiagnosis,positive predictive value and negative predictive value of Roman IV standard criteria in the diagnosis of biliary pain in China were 22.49%,87.27%,77.51%,12.73%,75.58% and 60.87%,respectively.2.Compared with patients with typical symptoms and patients with atypical symptoms,there was no significant difference in gender,age,marital status and education level(P>0.05);The proportion of patients with nocturnal pain awakening,anorexia and no trigger pain was significantly higher(P<0.05).There was no significant difference in postoperative pathology and concomitant diseases(P>0.05).The proportion of patients who also like drinking tea was statistically significant(P<0.05).There was no significant difference in lifestyle(P>0.05),but the proportion of patients who also liked drinking tea was higher(P<0.05).There was no significant difference in basic information between patients with FGBD and patients with organic diseases(P>0.05).The proportion of patients with pain in typical parts,the nature of pain and the pain that affects their daily life or forces them to seek first aid is high.The proportion of patients with rough gallbladder wall was higher in postoperative pathology.Among patients with atypical symptoms of FGBD,the proportion of patients with rough gallbladder wall was significantly higher than that of patients with organic diseases after subdivision,with no significant difference(P>0.05).Correlation analysis showed that the duration of symptoms over 30 minutes was related to gallbladder size(P<0.05).There was no significant difference in lifestyle between the two groups(P>0.05).The anxiety rate of FGBD patients was significantly higher than the organic disease group(P<0.05).At the same time,according to the binary multivariate logistic regression analysis,anxiety was the risk factor of FGBD in patients with cholestasis(P<0.05).Conclusion: 1.Rome IV standard has certain applicability in China.Although it can not be used as a necessary condition for the diagnosis of biliary pain,it is of great value.Patients who meet the diagnosis have a high probability of diagnosis.The remission rate of patients who meet the Rome IV standard symptoms after LC is relatively high,regardless of whether they have organic lesions or not,which can be used as an important guidance for surgery.3.FGBD patients were significantly more affected by psychological factors.Clinicians should consider whether the patients have psychological problems such as anxiety during diagnosis,and give appropriate treatment if necessary.4.The majority of patients with FGBD have inflammatory changes in gallbladder pathology after operation,and even the proportion of patients with rough gallbladder wall was higher. |
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