550例大肠息肉的临床病理分析、内镜下治疗及随访

本文报道５５０ 例大肠息肉的临床及病理特点、内镜下治疗及１～２０ 年随访结果。大肠息肉的检出率为１４．０％ ，５０ 岁以上患者占 ４９．１％ ，单发性息肉 ４２０ 例，多发性息肉 １３０ 例，好发部位为乙状结肠和直肠（５０．５％ ）。病理诊断以腺瘤性息肉（４２．２％ ）和炎性息肉（４０．０４％ ）最多，息肉的异型增生发生率为１４．２％ ，腺瘤性息肉的癌变率为 １２．１％ ，结肠癌伴息肉的发生率为 ２．９％ 。对５４４ 例患者进行了内镜下息肉治疗，息肉的复发及再发率为５５．４％ ，平均复发时间为 ３２ 个月。随访检出４ 例息肉癌变，分别在术后第 ３、５、１０、２０ 年。

Clinicopathologic Investigations,Endoscopic Treatment and Fellow up on 550 Patients with Large Bowel Polyps

Five hundred and fifty cases of large bowel polyps discovered by colonoscopy from 1976 to October 1996,among whom,544 patients were treated with therapeutic endoscopy and 193 patients were followed up for 1 to 20 years.The resuts showed that the disease frequencies of polyps were 14.0%,with a mean age 50 years,and 50.5% of the polyps were located in sigmoid colon and rectum.Histologically,adenomatous polyps were 42.2%,inflammatory polyps 40.4%,hyperplastic polyps 8.0%,hamartomatous polyps 0.7%,cancerous change 5.8% and large bowel carcinomas accompanying polyps 2.9%.Large bowel polyps were removed with biopsy forceps.electrocautery,wire loop or microwave.The recurrence of polyps or new polyp formation were detected in 107 patients(55.4%) with the mean recurrence time 32 months and cancerous change of the polyps in 4 patients.Our results indicated that the subjects who were under 50 years of age were also susceptible to the large bowel polyps;The adenomatous polyps in large bowel were easily cancerous change;Endoscopic treatment of the large bowel polyps was safe and effective.