西北某地内镜下诊治小儿结直肠息肉的临床研究

摘要

目的 探讨西北某地结肠镜对小儿结肠息肉的诊断和治疗价值.方法 对2015年1月-2016年12月诊断的112例1~18岁患者的结肠镜检查及治疗资料进行回顾性分析.在该项研究中评估的临床变量包括:性别,年龄,症状,发病年龄的症状,息肉的识别年龄,间隔时间之间的症状和内镜诊断结肠息肉,结肠息肉和/或结直肠癌家族史.息肉的特征还包括:数量,形态类型,直径,组织学和分布.笔者对人口统计,临床过程,实验室检查结果,内镜和病理组织学特征,治疗和结果进行了分析.结果 在112例患者中,年龄中位数为6.9岁,其中男占64.3%(72/112).所有患者有便血的症状,只是小部分患者有腹痛症状、肛门息肉和腹泻.9.8%(11/112)轻度贫血,贫血的患者都有6个多月的便血症状,与息肉部位无关.91.9%(103/112)的患者被确定为幼年性息肉,炎性息肉为7.1%(8/112),0.9%(1/112)被确定为腺瘤.1.8%(2/112)的患者有结肠息肉的家族史,无结直肠癌家族史.结论 该地区儿童结直肠息肉发病率较高.男性明显多于女性.小部分患者有家族性结直肠息肉病史无结直肠癌家族史.小部分便血患者有轻度贫血.息肉主要位于直肠和乙状结肠.幼年型息肉为主要病理类型,其次为炎性息肉和腺瘤.腺瘤可能位于直肠和乙状结肠以外的其他地方.%Objective To investigate the characteristics of the colon polyp in a northwest district of China. Methods 112 cases of patients from 1~18 years old, diagnosed with polyps by means of colonoscopies reference centers were followed-up from January 2015 to December 2016. The clinical variables evaluated in this study included: gender, age, symptoms, age at onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of colon polyp and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, diameter, histology, and distribution. The case records of these patients were reviewed. The demographics, clinical course, laboratory results, endoscopic and histopathological features, treatments, and outcomes were analyzed. Results In the 112 patients, the median age was 6.9 years, of which 64.3% (72/112) were male. All the patient had the symptom of hematochezia and just a little of the patients have the symptoms of abdominal pain, prolapse of anal polyp and diarrhea. 9.8% (11/112) was mild anemia and the anemia patient all had the symptom of hematochezia of more than 6 months and have no connection with the polyp location. Juvenile polyps were identified in 91.9% (103/112) patients, inflammatory polyp were identified in 7.1% (8/112) and 0.9% (1/112) were identified with adenoma. 1.8% (2/112) of the patient had the family history of colorectal polyp. Conclusions The morbidity of colorectal polyp in children and adolescents in our region is high. The male was significantly more common seen than female. A little proportion of the patient had the family history of colorectal polyp. The hematochezia could be seen in all patients A little proportion of the patient was mild anemia and the anemia patient all had the symptom of hematochezia of more than 6 months. Mainly the polyp was located in the rectum and sigmoid. Juvenile polyps were the major pathologic type and then the inflammatory polyp and adenoma. The adenoma may located in other place than rectum and sigmoid.