不同年龄层次、伴随症状便血原因分析

A analysis of hematochezia among different age combined with clinical sympotom

目的分析不同年龄层次及伴随症状便血原因。方法选取2014年1月~2015年12月因便血在本院进行肠镜检查的308例患者,分为青年、中年、老年3个组,记录3组患者肠镜检查结果,分析不同组别便血原因,并结合临床症状,分析不同便血原因伴随症状出现情况。结果青年组便血以肛周疾病为主(53.03%),未见肿瘤及缺血患者,中年组以肛周病变、息肉为主,比例分别为40.22%、20.65%,肿瘤、缺血的比例仍较低,老年组以肿瘤、息肉、缺血为主,所占比例分别为32.76%、29.31%、25.86%,其中肿瘤检出率3组之间差异有统计学意义(X^2=50.72,P<0.01;X^2=51.06,P<0.01;X^2=7.47,P<0.01),息肉检出率在老年组、中年组与青年组相比差异有统计学意义(X^2=27.99,P<0.01;X^2=18.38,P<0.01),缺血的检出率在老年组与中、青年组相比差异有统计学意义(X^2=38.84,P<0.01;X^2=62.32,P<0.01)。肠道病变,尤其是缺血性病变,肿瘤性病变伴随症状较多,而肛周病变多无明显伴随症状。结论青年患者便血多无明显伴随症状,以肛周良性病变为主,中老年便血患者,尤其是有腹部伴随症状的患者,出现缺血性病变、肿瘤、息肉等肠道疾病的几率较高,应尽早行肠镜检查。

Objectlve To explore the cause of hematochezia among different age group and associated symptoms.Methods The related information of308colonoscopies performed from2014to2015with hematochezia in our Hospital were collected.These patients were divided to youth group,middle age group,old age group.The enterscopy results were recorded.The different causes of hematochezia were analyzed.Associated symptoms of different causes were also analyzed.Results Crissum diseases were the major cause in the youth group(53.03%),no tumor and ischemic bowel disease were discovered.In the middle group,Crissum diseases,intestinal polyp were the importent constituent part(40.22%,20.65%),while that were tumor,intestinal polyp and ischemic bowel disease in the old age group(32.76%,29.31%,25.86%).There were significant difference of tumor ratio among the three group(c2=50.72,P<0.01;c2=51.06,P<0.01;c2=7.47,P<0.01).There were significant difference of intestinal polyp ratio between the youth and the other group(c2=27.99,P<0.01;c2=18.38,P<0.01).There were significant difference of ischemic bowel disease ratio between the old age group and the other group(c2=38.84,P<0.01;c2=62.32,P<0.01).Intestinal diseases were always accompanied with other sympotom.Crissum diseases were accompanied with fewer other sympotom.Conclusion The major blood stool cause in the youth who with fewer associated symptoms were Crissum diseases.The rate of tumor,ischemic bowel disease,intestinal polyp rised obviously in the middle age and old,especially for those with associated symptoms.These people need enteroscopy as early as possible.