小儿大肠息肉病内镜诊治20年回顾

Review of Diagnostic and Therepentic Endoscopies in the Past 20 Years on Children Colorectal Polyposis

６１８ 例小儿结肠镜检查发现大肠息肉４０７ 例，对其中３３４ 例（ 共３８５ 枚） 进行了息肉切除。３８５ 枚息肉的肠段分布依次为直肠２１９ 枚（５６－８８％ ），乙状结肠１０１ 枚（２６－２３ ％） ，降结肠３６ 枚（９－３５ ％） ，其它部位２９ 枚（７－５３ ％） 。息肉的病理类型幼年性息肉为２０２ 例（６０－４８％ ），腺瘤性息肉９０ 例（２６－９５％ ），炎症性息肉３２ 例（９－５８ ％ ），增生性息肉１０ 例（２－９９ ％） 。发现色素斑息肉综合征３ 例，家族性息肉病２ 例。全部息肉切除病例无大出血、穿孔等并发症。提示高频电凝切除小儿大肠息肉是安全、有效的治疗方法。对１０３ 例患儿进行了５ 年跟踪随访，结果发现１７ 例有息肉复发，并再次行息肉切除术。

In the past 20 years,618 colonoscopies were carried out in children,with 407 colorectal polyps discovered.Among the polyps,334 were resected,with 219 rectal polyps (56.88%),101 sigmoid colonal polyps (26.23%),36 decending colonal polyps (9.35%) and 29 polyps located in other positions.The pathological classification of the polyps is as follow:Juvenile polyps in 202 cases (64.48%),Adenomateus polyps in 90 cases (26.95%),Inflammatory polyps in 32 cases (9.58%),Hyperplastic polyps in 10 cases (2.99%).Three cases of P J syndrom and 2 cases of familial polyposis were found.Complications of severe hemorrage or perforation were observed in none of the cases of polypectomy,which suggests that polypectomy on children with high frequency of electronic coagulation is a safe and effective method.One hundred and three cases were followed endoscopically for five years,and 17 cases were found with polyps recurrence,then the polyps were also resected.