西宁地区结直肠腺瘤患者临床特点分析

发布时间：2018-07-27 18:59

【摘要】：目的:通过收集西宁地区结直肠腺瘤患者的临床资料,分析本病的临床、内镜及病理特点,为西宁地区结直肠腺瘤和结直肠癌的防治积累一定的临床资料。方法:选取2011年1月至2016年12月期间于青海大学附属医院、青海省红十字医院、西宁市第一人民医院、西宁市第二人民医院经结肠镜及病理诊断为结直肠腺瘤并行内镜下治疗的住院患者576例,收集患者的性别、年龄、民族、临床表现、内镜资料、病理资料,对其进行回顾性研究。结果:(1)本组资料中病例576例,男与女之间的比例为1.87:1;年龄在21~84岁之间,平均年龄55.67±11.39岁;汉族466人(80.9%),藏族72人(12.5%),其他民族38人(6.6%);症状主要为便血172例(29.9%),其次是腹泻137例(23.8%),腹痛111例(19.3%);(2)检出腺瘤1392枚,直径小于1cm的939枚(67.5%),单发245人(42.5%),多发331人(57.5%),病理类型当中管状腺瘤所占比例最高(75.7%),直肠(27.7%)与乙状结肠(26.5%)高是高发部位;(3)直径大于1cm的腺瘤中绒毛状腺瘤所占比例最高,与其他病理类型相比,有统计学差异(P0.01);(4)性别、年龄与腺瘤的生长部位无统计学差异(P0.05);(5)60岁以上年龄组中直径大于1cm的腺瘤比例高,与其他两个年龄组相比,差异有统计学意义(P0.01);(6)中老年组女性腺瘤患者所占比例高于青年组,具有统计学意义(P0.05);(7)藏族青年人腺瘤比例较中老年组高,差异有统计学意义(P0.05);(8)管状腺瘤中汉族患者比例最高,绒毛状腺瘤中藏族患者比例最高(P0.01);(9)性别及腺瘤生长部位及生长情况在民族中比较无统计学意义(P0.05)。结论:(1)西宁地区结直肠腺瘤患者以大于45岁的居多,男性多于女性,多发较单发常见,随着年龄的增大,直径大于1cm的腺瘤比例增加,且女性患者所占比例增加;(2)便血是结直肠腺瘤的主要预警症状;(3)腺瘤的直径越大,绒毛状腺瘤比例越高;(4)腺瘤好发的部位仍然是直肠及乙状结肠,与结直肠癌的流行病学特点相符合。
[Abstract]:Objective: to analyze the clinical, endoscopic and pathological features of colorectal adenoma in Xining area, and to accumulate some clinical data for the prevention and treatment of colorectal adenoma and colorectal cancer in Xining area. Methods: from January 2011 to December 2016, the hospital affiliated to Qinghai University, the Red Cross Hospital of Qinghai Province and the first people's Hospital of Xining City were selected. 576 cases of colorectal adenoma diagnosed by colonoscopy and pathology in Xining second people's Hospital were treated with endoscopy. The sex, age, nationality, clinical manifestation, endoscopic data and pathological data of the patients were collected. A retrospective study was carried out on it. Results: (1) there were 576 cases in this group, the ratio of male to female was 1.87: 1, the average age was 55.67 卤11.39 years. 466 (80.9%) of Han nationality, 72 (12.5%) of Tibetan nationality and 38 (6.6%) of other nationalities, the main symptoms were hematochezia in 172 cases (29.9%), diarrhea in 137 cases (23.8%), abdominal pain in 111 cases (19.3%); (2) and adenoma in 1392 cases. There were 939 (67.5%) in diameter smaller than 1cm, 245 (42.5%) in single cases, and 57.5% in multiple tumors (57.5%). The proportion of tubular adenoma was the highest (75.7%), and the high incidence of rectum (27.7%) and sigmoid colon (26.5%), (3) villous adenoma with diameter larger than 1cm accounted for the highest. Compared with other pathological types, there was a significant difference in sex (P0.01); (4). There was no significant difference between age and the growth site of adenoma (P0.05); (5). The proportion of adenoma larger than 1cm was higher in the age group over 60 years old than that in the other two age groups, compared with the other two age groups. The difference was statistically significant (P0.01); (6) the proportion of female adenoma in the middle and old age group was higher than that in the young group (P0.05); (7), the proportion of Tibetan young adenoma was higher than that in the middle and old age group, and the difference was statistically significant (P0.05); (8) the proportion of Han nationality patients with tubular adenoma was the highest. The proportion of Tibetan patients in villous adenoma was the highest (P0.01); (9). There was no significant difference in sex, growth location and growth of adenoma in ethnic group (P0.05). Conclusion: (1) the majority of patients with colorectal adenoma in Xining area are over 45 years old, male is more than female, more common than single, and the proportion of adenoma larger than 1cm increases with the increase of age. And the proportion of female patients increased; (2) hematochezia was the main early warning symptom of colorectal adenoma; (3) the larger the diameter of adenoma, the higher the proportion of villous adenoma; (4) the rectum and sigmoid colon were still the most common site of adenoma. In accordance with the epidemiological characteristics of colorectal cancer.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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