电子直乙肠镜在高龄人群肛肠疾病筛查中的应用价值

Application value of electronic rectosigmoidoscope in screening of anorectal diseases in elderly population

目的了解社区高龄人群肛肠疾病的发生情况,同时评价电子直乙肠镜在肛肠疾病筛查中的作用。方法对北京市西城区西长安街区60~74岁常住人口采用填写危险因素评估调查问卷的方法完成初筛,将初筛结果阳性者列为高危人群,给予电子直乙肠镜检查进行诊断性复筛。结果共有4782位筛查对象,实际参加初筛4347人,初筛阳性2997人(阳性率为68.9%),其中参加电子直乙肠镜检查2312人,顺应率为77.1%。电子直乙肠镜检查共检出各类肛肠疾病2275人,其中痔1311人(56.7%)、结直肠息肉458人(19.8%)、肛乳头肥大154人(6.7%)、直肠炎147人(6.4%)、肛裂103人(4.4%)、肛瘘52人(2.2%)、直肠黑变病33人(1.4%)、疑似直肠癌17人(0.7%);未见异常37人(1.6%)。男性人群中结直肠息肉、直肠炎、肛瘘的检出率要高于女性(P<0.05),而痔、肛乳头肥大、肛裂、直肠黑变病的检出率则是女性高于男性(P<0.05)。结论从本研究结果看,电子直乙肠镜作为筛查工具,具有操作简便、受检者依从性好、复筛顺应率高等特点,适用于社区高龄居民肛肠疾病的大范围筛查。

Objective To understand the prevalence of anorectal diseases in the elderly in the community,and to evaluate the role of electronic rectosigmoidoscope in the screening of anorectal diseases.Method The resident population aged 60–74 in the Xichang’an Street Area of Xicheng District of Beijing were collected to complete the initial screening by filling in the risk factor assessment questionnaire,and who were classified as the high-risk with positive initial screening were admitted to the diagnostic re-screening by electronic rectosigmoidoscope.Results There were 4782 screening subjects,while 4347 people actually participated in the initial screening,and 2997 people were positive(positive rate was 68.9%).Among them,2312 participated in the electronic rectosigmoidoscope screening,and the compliance rate was 77.1%.A total of 2275 patients with various anorectal diseases were detected by electronic rectosigmoidoscope,1311(56.7%)of whom were hemorrhoids,458(19.8%)were rectal polyps,154(6.7%)were anal papillary hypertrophy,147(6.4%)were proctitis,103(4.4%)were anal fissure,52(2.2%)were anal fistula,33(1.4%)were rectal melanoma,and 17(0.7%)were suspected rectal cancer.The detection rates of rectal polyps,proctitis,and anal fistula in the men were higher than those in the women(P<0.05),while the detection rates of hemorrhoids,anal papilla hypertrophy,anal fissure,and rectal melanosis in the women were higher than those in the men(P<0.05).Conclusions As a screening tool,electronic rectosigmoidoscope has the characteristics of simple operation,good compliance of the subject,and high compliance rate for re-screening.It is suitable for large-scale screening of anorectal diseases for elderly residents in the community.