纤维结肠镜诊断老年人大肠癌101例分析

The analysis of 101 cases of colorectal carcinoma in old fatients diagnosed with fiberocolonoscopy

目的为探讨老年人大肠癌的发病特点，提高老年人早期大肠癌的检出率，改善老年人大肠癌的预后。方法对３６５例有下消化道症状的老年人进行纤维结肠镜检，对照组１为同期非老年（＜６０岁）组，对照组２为同期老年前期（５０～５９岁）组。结果３６５例中检出大肠癌１０１例，检出率为２７．７％；对照组１检出率为６．４％（Ｐ＜０．０１），对照组２检出率１４．４％（Ｐ＜０．０１）。其分布在左半结肠者８０．４％；误诊率为６０．４％，其中院外误诊４０．６％，院内误诊１９．８％。结论老年人应列为大肠癌发病的高危人群，无症状老年人开展筛检普查，对可疑病人进行纤维结肠镜检查，全面体检者，纤维结肠镜应列为常规检查，这是改善老年人大肠癌预后的有效方法。

Objectives To explore the characteristics of colorectal carcinoma in old patients for the increase in diagnosis rate of early colorectal carcinoma and inprovement in prognosis of the patients of colorectal cancer. Methods Fibercolonoscopy was performed on 365 old ages(>60 years old) with symptoms of lower digestive tract. Control groups were the patients under age of 60 (group 1) and aged 50 to 59 years old (group 2). Results Colorectal carcinoma was noted in 101 with an incidence of 27.7%. The incidence of control group 1 was 6.4% and 14 .4% in control group 2. This difference was significant.80.4% carcinoma of colon cancer in the left side of the colon. 60.4% of the cases were misdiagnosed before fibercolonoscopy (40.6% in other hospital. 19.8% in our hospital ). Most patients attending a hospital presented with advanced cancer of the colon.Conclusions This analysis suggests that the risk for colorectal carcinoma increase significantly at old ages. Old ages should be taken as high risk group of colorectal carcinoma . It is necessary that screening should be done on old ages with asymptoms. When patients presents a chang in bowel habits ,fiberocolonoscopy should be performed. Further more, fiberocolonoscopy can be a means of routine examination to subjects who undergo general check-up