结肠镜检查5690例患者的适应证及疾病分布特征

目的探讨结肠镜检查与各适应证对应的疾病分布。方法回顾性分析2000年1月至2004年12月间进行的5690例结肠镜检查患者的检查结果。结果男性3096例,女性2594例;年龄(52±15)岁。患者进行结肠镜检查的原因:26.9%为便血;25.8%为不典型腹部疼痛;11.1%为腹泻、大便次数增多或大便不成形;7.6%为肛门坠胀、疼痛不适;7.0%为便秘;3.0%为排黏液或脓血便;0.9%为体检发现直肠肿块和腹部包块;10.9%为结肠镜息肉摘除术后复查;1.5%为结直肠癌术后复查;2.2%为单纯体检者;其余3.1%为其他原因进行检查者。结肠镜到达回盲部的比例为97.7%,共发现各种疾病2283例(40.1%)。其中结直肠癌10.3%,结直肠息肉19.6%,溃疡性结肠炎4.3%,克罗恩病0.5%。结论应对出现便血、非特异性腹痛、腹泻或便秘者和结直肠癌术后、结直肠息肉及结直肠癌遗传受累者进行定期的结肠镜检查。

Indications for colonoscopy examination and its disease distribution:a report of 5690 cases

OBJECTIVE: To explore the indications for colonoscopy examination and the distribution of diagnostic diseases. METHOD: From Jan. 2000 to Dec. 2004, 5960 patients received colonoscopy examination in our colorectal center. The indications for colonoscopy examination and the distribution of its diagnostic diseases were analyzed. RESULTS: There were 3096 males and 2594 females,and the mean age was (52+/-15) years. The reasons for colonoscopy included hemafecia (26.9%), atypical abdominal pain (25.8%), diarrhea or increased frequency of stool (11.1%), anal tenesmus or discomfort (7.6%), constipation (7.0%),mucous or bloody purulent stool (3.0%), intra-rectal mass or abdominal mass on physical examination (0.9%), re- examination after colonoscopic polypectomy (10.9%), re-examination after operation for colorectal cancer(1.5%), simple health examination (2.2%). Colonoscope reached the cecum in 97.7% of the cases,and at least one disease was found in 2283 cases (40.1%). Among them,colorectal cancer accounted for 10.3%, colorectal polyps 19.6%, ulcerative colitis 4.3%, and Crohn's disease 0.5% respectively. CONCLUSION: The indications for colonoscopy are too strict to screen the early stage colorectal cancer. Colonoscopy should be performed in the cases with symptoms such as bloody stool, diarrhea, abdominal pain, constipation, or with colorectal polyps, after operation for colorectal cancer,or as members of hereditary colorectal cancer family.