老年人大肠息肉的临床分析

目的探讨老年人大肠息肉的临床特点及其与癌变的关系。方法对该院收治的大肠息肉患者临床资料进行回顾性分析,按照年龄分为两组:60岁以上者为老年组,60岁以下者为青中年组。比较两组患者息肉部位、大小与病理类型及癌变率的关系。结果老年人大肠息肉的检出率、癌变率分别为29.3%及25.2%,均显著高于青中年组的9.7%及6.9%(P<0.01)。两组左半结肠息肉的患病率均高于右半结肠(P<0.05)。病理类型以腺瘤性息肉为多,占76.5%,也明显高于青中年组的腺瘤性息肉。其中以管状腺瘤最多,绒毛状腺瘤癌变率最高(P<0.01),息肉体积大(>2cm)、基底宽、数量多,癌变率高。结论老年人大肠息肉中的腺瘤性息肉患病率高,老年人应尽量行全结肠检查,发现腺瘤性息肉,不管大小,完整切除,定期随访,减少癌变的机会。

Clinical Analysis of Colonic Polyps in aged People

Objective To evaluate the characteristics of the colonic polyps in aged people,and to analyze the relationship between the colonic polyps and the malignant chang. Methods The clinical data of the patients with colonic polyps treated in our hospital from Jan.2010 to Jan.2013 were analyzed retrospectively.According to their age,they were divided into two groups：elderly group（≥ 60 years old）and young and middle-aged group （〈60 years old）.The relationship of colonic polyps predilection site and size,pathological type and the malignant chang rate was compared between the two groups. Results the detective rate and the malignant chang rate of colonic polyps in the aged people were29.3% and 25.2%.respectively,being significantly higher than that of the young and middle-aged people 9.7%and6.9% （P〈0.01）. The morbidity rate of left half colonic polyps was higher than that of right half colonic polyps in the two groups（P〈0.05）.The colonic polyps in the aged group were predominantly adenomatous polyps（76.5%）,being significantly higher than that in the young and middle-aged group. Among adenomatous polyps,tubular adenoma was the most, the malignant chang rate of villous adenoma was the highest （P〈0.01）,the larger in size （〉2 cm）and the broader in fundus and the more in number,the higher frequency of malignancy the polyps. Conclusion The prevalence rate of adenomatous polyps is higher in aged group than in young and middle-aged group,aged patients should be examined by endoscopy for all colon and extirpated adenomatous polyps regardless of size,and be followed-up periodically in order to prevent them from malignant transformation.