2001-2020年某医院35687例结直肠病患者肠镜检查结果

Analysis of colonoscopy results of 35687 cases of colorectal disease from 2000 to 2020

目的分析永煤集团总医院近20年接诊的结直肠病患者肠镜下结直肠病变检出状况。方法分析2001-2020年永煤集团总医院收治的35687例结直肠癌和结直肠息肉患者的临床资料。以5年为一个阶段将研究对象分为A组(2001-2005年,n=5132)、B组(2006-2010年,n=6473)、C组(2011-2015年,n=9921)和D组(2016-2020年,n=14161);比较各组患者年龄分布、临床表现、病变部位和病理分型情况。结果A组患者年龄18~90岁,平均(64.55±5.19)岁;B组18~96岁,平均(58.17±5.44)岁;C组18~91岁,平均(54.56±6.19)岁;D组18~88岁,平均(50.09±5.58)岁。患者的发病年龄呈现年轻化趋势,但总体以40~69岁人群为主。近20年结直肠病患者就诊时临床表现主要为腹痛、便血、腹部包块、大便习惯改变和肠梗阻等,其中腹痛一直为主要症状,而近年来便血、腹部包块、肠梗阻的患者减少。近20年结直肠部病变部位有左移趋势,升结肠发病率减少,降结肠和乙状结肠发病率增加,且多部位发病率减少,乙状结肠为主要发病部位。近20年结肠息肉仍以炎性息肉和管状腺瘤为主,其中炎性息肉发病率升高,管状腺瘤发病率降低;结直肠癌仍以中分化腺癌为主,且中分化腺癌发病率升高,高分化和低分化腺癌发病率降低。结论近20年永煤集团总医院结直肠病变患者逐年增加,主要发病人群为40~69岁人群,乙状结肠为主要发病部位,结直肠息肉和管状腺瘤以炎性息肉为主,结直肠癌以中分化腺癌为主,肠镜检查时应重点观察。

Objective To analyze the detection of colorectal lesions under colonoscopy in a hospital for recent 20 years.Methods Clinical data of 35687 patients with colorectal cancer and colorectal polyps admitted to a hospital from January 2000 to December 2020 were retrospectively analyzed.The study subjects were divided into group A(2000-2005,n=5132),group B(2006-2010,n=6473),group C(2011-2015,n=9921),and group D(2016-2020,n=14161).The age distribution,clinical manifestations,lesion sites and pathological types of patients in each group were compared.Results Patients in group A were 18-90 years old,with an average of(64.55±5.19)years old;group B was 18-96 years old,with an average of(58.17±5.44)years old;group C was 18-91 years old with an average of(54.56±6.19)years old.The D group was 18-88 years old,with an average age of(50.09±5.58)years old.The age of onset of the four groups of patients gradually showed a younger trend,but the middle-aged population of 40~69 years old was the main population.In the past 20 years,patients with colorectal lesions mainly showed abdominal pain,blood in the stool,abdominal mass,changes in bowel habits,and clinical manifestations of intestinal obstruction.Among them,abdominal pain has been the main symptom,and in recent years,patients with blood in the stool,abdominal mass,and intestinal obstruction have decreased.In the past 20 years,there has been a leftward shift of sites in the lesions of the colorectal,the incidence on the site of ascending colons has decreased,the incidence on the site of descending colon and sigmoid colorectal has increased,and the incidence of multiple parts has decreased.The sigmoid colorectal is the main site of colonic lesions.In the past20 years,Inflammatory polyps and tubular adenomas were still the main causes of colorectal polyps.The incidence of inflammatory polyps increased,the incidence of tubular adenomas decreased,and colon cancer still dominated by moderately differentiated adenocarcinoma.The rate of moderately differentiated adenocarcinoma was increased,and the incidence of highly differentiated and poorly differentiated adenocarcinoma was reduced.Conclusion The patients with colorectal disease in our hospital have increased year by year.The main affected population is the middle-aged population of 40-69 years old.The sigmoid colorectum is the main site of infection.Inflammatory polyps and tubular adenomas were still the main causes of colorectal polyps,and the colorectal cancer is mainly composed of moderately differentiated adenocarcinoma,which should be the focus on observation when colonoscopy.