结直肠息肉患者的临床和内镜特征研究

The Clinical and Endoscopic Characteristics of Patients with Colorectal Polyps

目的:观察结直肠息肉患者的临床症状表现以及内镜下的息肉分布情况,比较临床症状与息肉大小分布的差异性。方法:选取2011年1月至2013年6月期间在我院诊断治疗的结直肠息肉患者412例作为研究对象。结肠镜下诊断患者的临床症状、内镜下息肉发生部位以及息肉大小。结果:412例结直肠息肉患者临床症状腹痛腹胀的发生率为36.7%,大便性状改变的发生率为17.2%,便血的发生率为22.6%,腹泻的发生率为9.2%,便秘的发生率为8.5%,贫血消瘦的发生率为5.8%。息肉分布在直肠和乙状结肠的比例较高,分布在回盲肠的比例最低。息肉直径不超过0.5cm的占43.54%,直径在0.6-1.0cm的占35.24%,直径大于1.1cm的占21.22%。消瘦与不消瘦患者的息肉大小比较差异具有统计学意义(P<0.05),便血与不便血患者的息肉大小比较差异具有统计学意义(P<0.05)。584枚息肉有359枚发生病变,均病变成腺瘤,病变率为61.6%。息肉发生腺瘤病变与息肉直径、数目与粘膜表面有关,与息肉分布位置无关。结论:结直肠息肉临床表现主要是便血、消瘦、便秘腹泻以及腹痛腹胀等,主要分布在直肠和乙状结肠,不同症状的患者息肉大小比例不同。

To observe clinical symptoms of patients with colorectal polyps and the distribu -tion of endoscopic polypectomy ,and to contrast the difference of clinical symptoms and polyp size .Mtehod：Choose 412 patients with colorectal polyps diagnosed and cured by our hospital from Jan .2011 to Jun.2013 as the research subject .Patients＇clinical symptoms , endoscopic polyp location as well as polyp size would be diagnosed under colon endoscopic .Result：The incidence rate of abdominal pain and distension from clinical symptoms of 412 patients with colorectal polyps was 36.7%.The incidence rate of the change of character of stool was 17.2%.The incidence rate of hematochezia was 22.6%.The incidence rate of diarrhea was 9.2%. The incidence rate of astriction was 8.5%.The incidence rate of anemia wasting was 5.8%.The proportion of polyps which distribute in rectum and sigmoid colon was higher while the proportion of polyps which distrib -ute in ileocecal was the lowest .The rate of polyp whose diameter was not beyond 0.5cm was 43.54%.The rate of polyp whose diameter was between 0.6-1.0cm was 35.24%.The rate of polyp whose diameter was be-yond 1.1cm was 21.22%.The contrastive difference of polyp size from marasmus patients and non-marasmus patients has statistical significance （P〈0.05）.The contrastive difference of polyp size from patients with he-matochezia and patients with non-hematochezia has statistical significance （P〈0.05）.584 polyps was 359 le-sions, disease into adenomas, pathological changes at a rate of 61.6%.Polyps in adenoma lesions associated with polyp diameter , number and mucous membrane surface , has nothing to do with polyps distribution posi-tion.Conclusion：The clinical symptoms of colorectal polyps mainly are hematochezia , macritus, constipa-tion and diarrhea as well as abdominal pain and distension and so on .The colorectal polyps mainly distributes in rectum and sigmoid colon .The proportion of polyp size of patients with different symptoms is different .