肛门良性疾病术前全结肠镜检查的临床意义

Clinical significance of preoperative colonoscopy for benign anal diseases

目的探讨肛门良性疾病患者术前应用全结肠镜检查的临床意义，比较无痛结肠镜检查和普通结肠镜检查的成功率。方法回顾性分析2010年4月至2011年3月中山大学附属第六医院收治的术前行全结肠镜检查的333例肛门良性疾病患者的临床资料。结肠镜检查发现结直肠病变患者为病变组（120例），未发现结直肠病变患者为正常组（213例）。根据结肠镜检查结果及检查方式进行分层分析。计量资料比较采用t检验，计数资料比较采用X^2检验。结果病变组患者的年龄为（48±14）岁，显著高于正常组的（42±14）岁，两组比较，差异有统计学意义（t=3．75，P〈0．05）。病变组40岁以上患者的构成比为72．50％（87／120），显著高于正常组的39．44％（84／213），两组比较，差异有统计学意义（X2=33．59，P〈0．05）。病变组男、女患者构成比分别为71．67％（86／120）和28．33％（34／120），正常组分别为62．44％（133／213）和37．56％（80／213），两组比较，差异无统计学意义（X^2=2．90，P〉0．05）。病变组结直肠病变包括息肉80例、肠炎30例、恶性肿瘤7例、炎性肠病7例、憩室5例、溃疡1例。无痛结肠镜在病变组和正常组中的应用率分别为51．67％（62／120）和54．93％（117／213），两组比较，差异无统计学意义（∥=0．33，P〉0．05）。无痛结肠镜检查到达回肠末段的成功率为99．44％（178／179），显著高于普通结肠镜检查的95．45％（147／154），两者比较，差异有统计学意义（X^2=5．61，P〈0．05）。结论肛门良性疾病患者可能合并结直肠病变，建议40岁以上患者术前行无痛全结肠镜检查。

Objective To investigate the clinical significance of preoperative colonoscopy for patients with benign anal diseases, and to compare the success rates of examination done by sedated colonoscopy and conventional colonoscopy. Methods The clinical data of 333 patients with benign anal disease who received preoperative colonoscopy at the Six Affiliated Hospital of Sun Yat-Sen University from April 2010 to March 2011 were retrospec- tively analyzed. All the patients were divided into the lesion group （120 patients） and normal group（213 patients） according to the results of colonoscopy. The measurement data and count data were analyzed using the t test and chi-square test, respectively. Results The age of patients in the lesion group was （48 ± 14 ）years, which was significantly older than （42 ±14） years （t = 3.75, P 〈 0.05）. The constituent ratio of patients older than 40 years in the lesion group was 72.50% （87/120）, which was significantly higher than 39.44% （84/213） in the normal group 0（2= 33.59, P 〈 0.05 ）. The proportions of male and female patients were 71.67% （86/120） and 28.33 % （34/120） in the lesion group, and 62.44% （133/213） and 37.56% （80/213） in the normal group, with no significant difference between the 2 groups 0（2 = 2.90, P 〉 0.05 ）. The benign anal diseases in the lesion group included polyp （80 eases）, enteritis （30 eases）, malignant tumor （7 cases）, inflammatory bowel disease （7 cases）, diverticulum （5 eases） and ulcer （1 ease）. The application rates of sedated colonoscopy in the lesion group and the normal group were 51.67% （62/120） and 54.93% （117/213）, respectively, with no significant difference between the 2 groups 0（2=0. 33, P 〉0.05）. The success rate of terminal ileum intubation was 99.44% （178/179） in patients who received sedated eolonoscopy, which was significantly higher than 95.45% （147/154） of patients who received conventional eolonoscopy （X2 = 5.61, P 〈 0.05 ）. Conclusion Patients with benign anal disease might complicated with coloreetal lesions, and sedated colonoscopy is recommended for preoperative diagnosis, especially for patients who are older than 40 years.