延安大学附属医院大肠肿瘤伺机性筛查及危险因素分析
发布时间：2019-05-28 00:37
【摘要】：目的:本研究分为两部分,第一部分:探讨高危因素问卷调查联合粪隐血试验对大肠病变初筛意义及可行性;第二部分:大肠肿瘤的相关危险因素分析。方法:第一部分:对2016年1月至2016年12月于延安大学附属医院就诊的40-75岁患者及无症状体检人群共计7200例,行大肠肿瘤危险因素评估问卷调查及免费粪隐血筛查试验,对初筛阳性者,进一步行结肠镜检查,汇总筛查结果,进一步分析。第二部分:对2012年1月至2016年12月于我院行结肠镜及病理组织学诊断为大肠癌患者427例,大肠腺瘤患者816例及同时段行结肠镜检查诊断为正常者,采用面对面调查及电话询问等两种方式完成高危因素问卷调查,对纳入资料行1:1病例-对照研究,并进行相关分析。结果:1.问卷调查阳性人群与问卷调查阴性人群粪隐血阳性率有显著性差异(X2=22.339,p0.05)。2.单纯问卷调查阳性者798例,接受结肠镜检查者359例,依从性44.99%,结肠病变检出率34.82%;单纯粪隐血阳性者24例,行结肠镜精筛者10例,依从性41.67%,病变检出率20.00%;初筛双阳性者29例,精筛依从性96.55%,结肠病变检出率为46.43%。三组病变检出率比较无显著性意义(x2=2.581,p=0.275)。3.对大肠癌组和对照组可能的易感及危险因素进行多因素Logistic回归分析结果显示:与少食或不食高脂类食品、腌制食品等相比,经常食此类物质的人患大肠癌风险增加,2型糖尿病、胆囊结石是大肠癌的危险因素,有下腹痛及慢性腹泻等临床症状表现的与大肠癌发生有相关性。4.对大肠腺瘤组和对照组可能的易感及危险因素进行多因素Logistic回归分析结果显示:经常食腌制类物质的人患大肠腺瘤风险增加,C型性格、吸烟史、家族史是大肠腺瘤的危险因素,慢性便秘与大肠腺瘤发生相关。结论:1.伺机性筛查可能为延安地区大肠肿瘤初筛较合理的模式。2.危险因素问卷调查及粪便潜血试验作为传统的大肠病变初筛方法依然有效,且在普通肠道病变的预示作用中,两者无明显差异。3.对于平均风险人群,伺机性筛查可早期检出大肠癌及相关癌前病变,对疾病尽早干预、改善结直肠癌的预后有重要意义。4.大肠癌危险因素有:经常食高脂类食品、腌制食品;有2型糖尿病病史、胆囊结石史;存在下腹痛及慢性腹泻等消化道临床症状。5.经常食腌制食品、C型行为类型、吸烟史、大肠肿瘤家族史及长期慢性便秘等为大肠腺瘤发生的危险因素。
[Abstract]:Objective: this study is divided into two parts: the first part: to explore the significance and feasibility of high risk factors questionnaire survey combined with fecal occult blood test for screening colorectal lesions; the second part: analysis of related risk factors of colorectal tumors. Methods: the first part: a total of 7200 patients aged 40 years and 75 years old and asymptomatic physical examination in the affiliated Hospital of Yan'an University from January 2016 to December 2016 were investigated by questionnaire on the risk factors of colorectal tumors and free fecal hidden blood screening test. For those who were positive for primary screening, colonoscopy was further performed, the screening results were summarized and further analyzed. Part II: from January 2012 to December 2016, 427 patients with colorectal cancer, 816 patients with colorectal adenoma and 816 patients with colorectal adenoma were diagnosed as normal by colonoscopy and pathology in our hospital. Face-to-face survey and telephone inquiry were used to complete the questionnaire survey of high risk factors. The 1:1 case-control study was included in the data, and the correlation analysis was carried out. Result: 1. There was significant difference in the positive rate of fecal occlusive blood between the positive population and the negative group (X2 鈮，
本文编号：2486575
[Abstract]:Objective: this study is divided into two parts: the first part: to explore the significance and feasibility of high risk factors questionnaire survey combined with fecal occult blood test for screening colorectal lesions; the second part: analysis of related risk factors of colorectal tumors. Methods: the first part: a total of 7200 patients aged 40 years and 75 years old and asymptomatic physical examination in the affiliated Hospital of Yan'an University from January 2016 to December 2016 were investigated by questionnaire on the risk factors of colorectal tumors and free fecal hidden blood screening test. For those who were positive for primary screening, colonoscopy was further performed, the screening results were summarized and further analyzed. Part II: from January 2012 to December 2016, 427 patients with colorectal cancer, 816 patients with colorectal adenoma and 816 patients with colorectal adenoma were diagnosed as normal by colonoscopy and pathology in our hospital. Face-to-face survey and telephone inquiry were used to complete the questionnaire survey of high risk factors. The 1:1 case-control study was included in the data, and the correlation analysis was carried out. Result: 1. There was significant difference in the positive rate of fecal occlusive blood between the positive population and the negative group (X2 鈮，
本文编号：2486575
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