190例老年患者大肠息肉的临床特点及治疗分析

Analysis of Clinical Characteristic and Therapy in 190 Cases Elderly Patients with Colonic Polyps

目的:研究老年大肠息肉的临床特点,探讨其安全有效的治疗办法。方法:收集驻马店市中心医院2009年1月-2013年12月期间经结肠镜施治的老年大肠息肉患者病例190例,进行回顾性分析内镜特点及治疗情况。结果:190例老年患者,共295枚息肉。发病部位分布:直肠占41.02%,乙状结肠占26.78%,降结肠占10.51%,横结肠占7.46%,升结肠占11.19%,盲肠占3.05%。病理类型分布:管状腺瘤占44.44%,绒毛状腺瘤占10.14%,管状绒毛状腺瘤占12.56%,炎性息肉占19.81%,增生性息肉占13.04%。其中239枚采取高频电切治疗术,56枚采用氩离子凝固术。高频电切除术中和术后共7例并发出血,发生率为2.37%。结论:老年患者大肠息肉好发于远端大肠,腺瘤性息肉较多见,需要及时治疗,行内镜下高频电切术、氩离子凝固术是治疗老年患者大肠息肉的简单、安全而有效的方法。

Objective：To analyze the clinical features and investigate safe and effective treatment of elderly patients with colonic polyps. Method：190 cases elderly patients with colonic polyps under endoscopic treatment admitted to Zhumadian Central Hospital between January 2009 and December 2013 were analyzed via a retrospective analysis. Result：Total 295 polyps were found in 190 cases elderly patients. polyps in the rectum,sigmoid, descending colon,transverse colon,ascending colon and cecum were respectively 41.01%,26.78%,10.51%,7.46%,11.19% and 3.05% respectively. The pathologic types were tubular adenoma（44.44%）, villous adenoma（10.14%）, tube villous adenomas（12.56%）, inflammatory polyp（19.81%）, hyperplastic polyp（13.04%）. 239 polyps were removed by high frequency electric resection,and the other 56 polyps with argon plasma coagulation（APC）. There were 7 patients intraoperative and postoperative bleeding, rate of 2.37%. Conclusion：Most of the colon polyps in elderly patients locate in distal colon. Adenomatous polyps were common pathological types. Timely treatment is needed. High frequency electric coagulation, argon plasma coagulation technique are simple,safe and effective treatment of elderly patients with colon polyps.