318例大肠息肉临床、内镜及病理特点分析

Characteristics of clinic,endoscopy and pathology for 318 cases of colorectal polyps

目的 分析大肠息肉患者的年龄、临床表现、息肉的发生部位、大小、病理类型等特点.方法 对电子结肠镜检查中检出并切除的大肠息肉患者的临床表现、内镜特点及病理资料进行总结和分析.结果 在318例大肠息肉患者中,男171例,女147例;好发年龄以30～69岁为主,占73.58％;临床表现以便血（54.18％）、腹痛（32.38％）及腹泻（8.62％）为主,并且男性患者以便血为首诊者较女性明显增高（P＜0.05）,而女性以腹痛为首诊者较男性明显增高（P＜0.05）.增生性息肉中男性就诊时间明显较女性短（P＜0.05）,且临床表现多为便血.息肉部位分布直肠最多,占33.55％,乙状结肠28.28％,降结肠21.72％,横结肠6.57％,升结肠7.25％,盲肠2.63％;炎性、增生性、腺瘤性、幼年性息肉分别占2.83％、29.24％、53.77％、14.16％;幼年性息肉、绒毛状腺瘤、混合性腺瘤体积较其他类型息肉明显增大.结论 30 ～69岁大肠息肉发病率较高,临床表现以便血、腹痛及腹泻为主;男性患者以便血为首诊者较女性明显增高,而女性以腹痛为首诊者较男性明显增高,增生性息肉中男性就诊时间明显较女性短,且临床表现多为便血;息肉好发部位为左半结肠;病理类型以增生性息肉和腺瘤性息肉常见;发现大肠息肉应尽可能切除,预防息肉癌变.

Objective To study the clinical, endoscopic and pathological characteristics of colorectal polyps. Methods The clinical and pathological characteristics in 318 patients with colorectal polyps were reviewed. Results In 318 patients with colorectal polyps, including 171 men and 147 women. The incidence rate of colorectal polyp was 73.58% in 30 - 69 year olds. The main clinical manifestation were hemafecia （54.18%）, abdominal pain （32.38%） and diarrhea （8.62%）. Hemafecia was more often in men than in women （ P 〈 0. 05）, but abdominal pain was more often in women than in men （P 〈 0. 05 ） when see a doctor at first time. Men in a short time than women in hyperplastic polyps （P 〈 0. 05 ）, and main clinical manifestations was hematochezia. Polypoid lesions were located at rectum（33.55% ）, sigmoid（28.28% ）, descending colon （21.72% ）, transverse colon （6.57%）, ascending colon （7.25 % ）, and cecum （2.63 % ）. The inflammatory, hyperplastic, adenomatous and juvenile polyps accounted for 2. 83%, 29. 24%, 53. 77% and 14. 16%, respectively. Juvenile polyps, villous adenoma and adenoma mixed were larger than other types in diameter. Conclusions The ages between30 - 69 tend to suffer from colorectal polyps. The main clinical manifestation were hemafecia, abdominal pain and diarrhea. Hemafecia was more often in men than in women, but abdominal pain was more often in women than in men when see a doctor at first time. Colorectal polyps are frequently observed in left colon. The common pathological types are hyperplastic and adenomatous polyps. All colorectal polyps should be excised to prevent colorectal polyp cancerization.