临床症状谱对结直肠癌诊断时间的影响

The Influence of Symptom Profile in the Diagnosis Time of Colorectal Cancer

目的探讨临床症状谱对结直肠癌诊断时间的影响。方法调取1 810份原发性结直肠癌病历资料,按随机数字表法从中抽取300例作为研究对象并进行回顾性研究。结果 300例结直肠癌患者首发症状按其发生频次排列:大便习惯改变165例次,腹痛或腹部不适90例次,便血80例次,肛门刺激症状45例次,黑便20例次,腹部包块15例次。125例(41.67%)患者同时出现2种或以上症状。出现便血患者确诊率为70.0%(56/80),与无便血患者[50.3%(83/165)]比较差异显著(χ2=8.517,P<0.01)。出现2种以上症状就诊者确诊率[68.0%,85/125]较单一症状就诊者(53.9%,89/165)确诊率高,差异显著(χ2=5.859,P<0.05)。结论结直肠癌患者以大便习惯改变、便血及腹痛为常见首发症状,患者就诊症状谱与首发症状谱类似,需早期发现,提高早诊率。

Objective To explore the influence of spectrum of typical symptoms in diagnosis time. Methods Clinical data of 300 colorectal cancer patients were retrospectively analysed. Results Primary symptoms in 300 colorectal cancer patients were arranged according to frequency ： defecate habit change 165 cases, abdominal pain or discomfort 90 cases, rectal bleeding 80 cases,anal irritation 45 cases,melena 20 eases,abdominal mass 15 cases. 125 cases （41.67%） presented multiple symptoms at the same time. The diagnosis rates of patients with and without rectal bleeding were 70.0% （56/80） and 50.3% （ 83/165 ） , there had significant difference（ ehi-square = 8. 517, P 〈 0.01 ）. Diagnosis rates of patients with more than 2 kinds of symptoms （68.0% ,85/125 ）were higher than those with one symptom （53.9%, 89/165 ）, there had significant difference （chi-square = 5. 859,P 〈 0.05）. Condusion Change in bowel habits,rectal bleeding and abdominal pain are the most common primary symp- toms of the eoloreetal cancer patients. Clinical and primary symptoms are similar. Timely detection can improve early diagnosis rate.