老年患者结肠镜检查的临床特点研究

Clinical Characteristics of Colonoscopy of Senile Patients

目的探讨老年患者结肠镜检查的临床特点。方法选取2015年2月—2016年2月在广东省人民医院行结肠镜检查的老年患者2 314例,根据是否存在消化道出血分为出血组(n=681)和非出血组(n=1 633)。分析老年患者的结直肠病变类型和检出率,并比较两组患者的结直肠病变差异。结果 2 314例老年患者的阳性检出率为81.7%(1 891/2 314),其中结直肠息肉、结直肠癌、结肠憩室、溃疡糜烂性病变的检出率分别为50.9%(1 179/2 314)、16.1%(373/2 314)、12.4%(286/2 314)、5.5%(127/2 314),出血组患者的结直肠癌检出率为47.0%(320/681)。出血组患者的阳性检出率(95.6%,651/681)高于非出血组(75.9%,1 240/1 633),差异有统计学意义(P<0.001)。与非出血组比较,出血组患者男性比例高,结直肠癌、溃疡糜烂性病变、血管畸变检出率高,结直肠息肉检出率低,差异有统计学意义(P<0.001);两组患者结肠憩室、结直肠黑变病检出率比较,差异无统计学意义(P>0.05)。结论结直肠息肉和结直肠癌是老年患者结肠镜检查中较为常见的阳性病变,且结直肠癌可能是导致老年患者下消化道出血的重要病因。

Objective To investigate clinical characteristics of colonoscopy of senile patients. Methods A total of 2 314 senile patients undergoing colonoscopy in Guangdong General Hospital from February 2015 to February 2016 were selected and divided into bleeding group （ n = 681 ） and non - bleeding group （ n = 1 633 ） according to whether there was gastrointestinal bleeding or not. The types and detection rates of colorectal lesions in senile patients were analyzed and the differences in eolorectal lesions between the two groups were compared. Results The positive detection rate of 2 314 senile patients was 81.7% （ 1 891 /2 314） , of which the detection rate of colorectal polyps, colorectal cancer, colonic diverticulum and ulcerative erosive lesions was 50. 9% （1 179/2 314）, 15. 1% （373/2 314）, 12.4% （286/2 314） and 5.5% （127/2 314） respectively, and the detection rate of coloreetal cancer in the bleeding group was 47.0% （320/681） . The positive detection rate of the bleeding group （95.5% , 551/681 ） was significantly higher than that in non - bleeding group （75.9% , 1 240/1 633 ） （ P 〈0. 001 ）. The proportion of male patients in bleeding group was significantly higher than that in non - bleeding group, and the detection rates of colorectal cancer, ulcer erosive lesions, vascular distortions were significantly higher than those in non - bleeding group and detection rate of colorectal polyps was significant lower than that in non - bleeding group （ P 〈 0. 001 ） . There was no significant difference in the detection rate of colonic diverticulum and colorectal melanosis between two groups （ P 〉 0. 05 ）. Conclusion Both colorectal polyps and eolorecta] cancer are the most common positive lesions in senile patients undergoing colonoscopy. Moreover, colorectal cancer may be an important cause of lower gastrointestinal bleeding in senile patients.