529例健康体检者结肠镜检查结果分析

Analysis of colonoscopy examination in 529 healthy adults

目的探讨健康人群体检时进行结肠镜检查的意义。方法选取北京协和医院体检中心于2010年1月至2011年6月期间接受结肠镜检查的健康体检者537例，其中529例成功接受了全结肠镜检查。统计受检者的性别、年龄、病变检出情况，包括检出率、类型、部位，并分析息肉检出率、病变部位与年龄和性别间的关系。结果529例受检者中男315例、女214例，平均年龄（48．3±9．3）岁，检出肠息肉104例（19．7％），其中进展期息肉17例（3．2％），腺瘤84例（15．9％），直肠癌1例（0．2％），痔疮61例（11．5％），结直肠炎症22例（4．2％）。结直肠息肉在男性中的检出率显著高于女性（P〈0．001）。年龄I〉50岁者结直肠息肉和进展期息肉的检出率均明显升高（P〈0．001，P〈0．05）。共检出息肉158枚，以〈0．5cm、管状腺瘤居多。随年龄增长，近端结肠息肉患者的比例增多，而远端结肠息肉患者的比例减少（P〈0．05）。结论结肠镜检查是筛查健康体检人群结直肠病变的有效手段，重视体检人群的结肠镜检查有助于结直肠癌的早发现早治疗。

Objective To explore the significance of colonoscopy examination in heahhy subjects. Methods A total of 537 health examination cases who underwent colonoscopy from January 2010 to June 2011 in Peking Union Medical College Hospital （PUMCH） health examination center were enrolled, in which 529 cases underwent total colonoscopy. Detection of colorectal lesion, polyp types and pathology were recorded and the correlation between detection rate of polyps, lesion sites and ages as well as gender were analyzed. Results There were 315 male and 214 female, with a mean age of 48.3 ±9. 3 years. A total of 158 colorectal polyps were detected in 104 cases （ 19. 7% ）, including 84 （ 15. 9% ） adenomas, 17 （3.2%） advanced polyps and 1 （0. 2% ） rectal cancer. Other abnormalities were hemorrhoids in 61 cases （11.5%） and inflammation in 22 （4. 2% ）. Colorectal polyps were more frequent in men （P 〈0. 001 ）. Adults older than 50 had higher rates of colorectal polyps （ P 〈 0. 001 ） and advanced polyps （ P 〈 0. 05 ）. The proportion of patients with proximal polyps increased with age, whereas that of patients with distal polyps decreased with age （P 〈 0. 05 ）. Conclusion Colonoscopy is an effective screening modality for colorectal lesions and the importance of colonoscopy on health examination population to prevent colorectal cancer should be stressed.