目的：了解老年胆囊切除患者结直肠腺瘤的临床特点，为老年结直肠癌的防治提供参考。方法纳入经肠镜检查发现息肉并行病理学检查提示为结直肠腺瘤的老年患者共1272例，除外恶性肿瘤、家族性腺瘤性息肉病、炎症性肠病。根据既往有无行胆囊切除手术分为胆囊切除组和对照组，比较两组患者结直肠腺瘤的数量、大小、发生部位、病理类型，并比较胆囊切除时间不同亚组的结直肠腺瘤的特征。结果胆囊切除组女性患者比例明显高于对照组（P＜0．05）；吸烟患者比例明显低于对照组（P＜0．05）；腺瘤个数多于对照组（ P＜0．05）；绒毛状腺瘤比例高于对照组（ P＜0．05）。恶变高风险息肉在胆囊切除时间不同的两个亚组中的比例差异无统计学意义（P＞0．05）。结论尽管与胆囊切除时间长短无关，老年胆囊切除患者结直肠腺瘤具有更高的恶变风险。%Objective To explore the clinical characteristics of colorectal adenomas in elderly patients with cholecys-tectomy, and provide some references for the prevention and treatment of this disease.Methods One thousand two hun-dred and seventy-two cases of elderly patients with colorectal adenoma who were found by colonoscopy and diagnosed by pathology were collected, except for malignant tumor, familial adenomatous polyposis and inflammatory bowel disease. They were divided into cholecystectomy group and control group according to whether did the cholecystectomy operation. The number, size, location, pathological type were compared between two groups, the characteristics of colorectal ade-noma were compared in different time of cholecystectomy.Results The proportion of female patients in the cholecystec-tomy group was significantly higher than that in the control group (P<0.05); the percentage of smoking patients was significantly lower than that in the control group (P<0.05);the number of adenoma was more than that of the control group (P<0.05);the proportion of villous adenoma was higher than that of the control group (P<0.05).There was no difference in the high risk of canceration of polyps between two subgroups (P>0.05).Conclusion The adenomas in the elderly patients with cholecystectomy have more chance to malignant transformation than those in the elderly pa-tients without cholecystectomy, no matter how long the interval after cholecystectomy.
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