老年人大肠息肉的临床表现及镜下治疗

目的探讨老年人(≥60岁)大肠息肉的临床特点及其镜下治疗。方法回顾性分析78例老年大肠息肉患者的临床资料,分析总结其息肉的大小、部位、形态、病理学特点及内镜治疗情况,并与同期39例中青年大肠息肉患者(<60岁)资料进行对比分析。结果老年组多发性息肉占50.5%,明显高于中青年组的19.8%(P<0.05);直肠、乙状结肠是息肉的好发部位,老年组大肠息肉检出率23.8%,明显高于中青年组的9.7%(P=0.000);两组大肠息肉分布比较差异无统计学意义(P>0.05);老年组直径≥1 cm、分叶状息肉及腺瘤性息肉的比例增高。结论老年人结肠镜检查是发现息肉的最有效手段,可放宽其适应证,并尽量使大肠镜检查达回盲部;内镜下摘除老年人大肠息肉安全、有效、简便,但应进行定期随访。

Features of colonoscopy diagnosis and treatment of polyps of large intestine in elderly

Objective To explore the clinical feature and the application of colonoscopy in the diagnosis and treatment of polyps of large intestine in the elderly.Methods The clinical data of 78 aged patients with polyps of large intestine(aged group) were retrospectively analyzed,including polyps size,position,shape and histological characters.In the same period,those data of 39 middle,young people with colonic and rectal polyps(middle-young group) were compared.Results The detection rate of the polyps of aged group was 23.8%,which was significantly higher than 9.7% of middle-young group(P=0.000).The multiple polyps accounted for 50.5% in aged group,significantly higher than that in middle-younge group,accounting for 19.8%(P=0.000).The ratio of adenomatous polyps,in diameter 1 cm and cauliflower like polyps was relatively increased.Conclusion The indication of colonoscopy test to the elderly should be broader and the whole colon must be examined.The colonoscopy therapy for removing the polyps in aged people is necessary and the regular follow-up should be taken.