儿童结直肠息肉670例临床分析

Clinical analysis of colorectal polyps in 670 children

目的探讨儿童结直肠息肉的临床特点以及内镜下黏膜剥离切除术(EMR)的治疗价值。方法回顾分析2012年至2017年收治的确诊为结直肠息肉后立即行EMR的患儿临床资料。结果 670例患儿中,男423例、女237例,平均确诊年龄(4.50±2.69)岁,高发于3～6岁(43.4%)。临床表现以便血(90.3%)为主。息肉以单发(92.5%)为主,多发于直肠(49.0%)及乙状结肠(35.2%);直径多<2 cm(78.9%)。息肉≥2 cm者需钛夹夹闭创面,而息肉直径<2 cm者钛夹对术后出血无影响。术后并发出血主要发生在术后第1天。术后病理回报提示以幼年性息肉为主。结论结直肠息肉高发于学龄前男童,以幼年性息肉为主;EMR辅以金属钛夹可减少术后出血。

Objective To explore the clinical features of colorectal polyps in children and the therapeutic value of endoscopic mucosal resection(EMR).Method The clinical data of 670 children with colorectal polyps who underwent EMR immediately after the diagnosis from 2012 to 2017 were retrospectively analyzed.Results Among 670 children(423 males,232 females),the average diagnosis age was 4.50±2.69 years old,with high incidence at the age of 3 to 6 years(43.4%).The clinical presentation was dominated by hemafecia(90.3%).Most of the polyps were solitary(92.5%),mostly in the rectum(49.0%)and sigmoid colon(35.2%)with diameter<2 cm(78.9%).For polyps with diameter≥2 cm,titanium clips should be used to close the wounds,while for those with diameter<2 cm,titanium clips have no effect on postoperative bleeding.Postoperative bleeding mainly occurred on the first day after operation.Postoperative pathological findings suggested that juvenile polyp was predominant.Conclusions Colorectal polyps are most common in preschool boys and most of them are juvenile polyps.EMR supplemented with metal titanium clips can reduce postoperative bleeding.