腹部单发症状患者结肠镜检查结果分析

目的观察结肠镜检查对腹部单发症状的临床意义。方法对2003年7月1日至2007年6月30日我院消化科871例具有腹部单发症状腹痛、腹泻、便秘或血便者的结肠镜检查结果作回顾性分析，按症状分为四组：腹痛组、腹泻组、便秘组及血便组。结果腹痛组患者肠癌与息肉的检出率分别为4．02％、14．66％：腹泻组患者肠癌与息肉的检出率分别为4．05％、14．86％；便秘组患者肠癌与息肉的检出率分别为5．26％、17．54％；血便组患者肠癌与息肉的检出率分别为25．66％、18．58％。息肉的检出率4组比较无统计学意义（χ^2=0．0017 P〉0．05）；肠癌的检出率腹痛组、腹泻组、便秘组间比较无统计学差异（χ^2=0．0662 P〉0．05），血便组与腹痛组、腹泻组、便秘组比较均有统计学差异（χ^2=69．42 P〈0．05）。大肠癌61例，男性与女性之间差异不明显（χ^2=3．67 P〉0．05）。右半结肠12例，左半结肠49例。〈30岁肠癌检出率为0，息肉检出率为3．39％；31—50岁肠癌检出率为2．78％，息肉检出率为11．42％；51—70岁，肠癌检出率为10．62％，息肉检出率为22．12％；〉70岁肠癌检出率为17．78％，息肉检出率为22．22％。结论血便可以作为大肠癌的报警症状，除血便外，医生不能单凭某一症状来判断结肠镜检查的可能性及阳性发现。乙状结肠镜检查可作为初选检查，但如果条件允许应行全结肠检查以免遗漏右半结肠病变。50岁以上患者应放宽结肠镜的检查范围，以发现早癌。

Abdominal single symptom and colonoscopy

Objective To explore the abdominal single symptom and the application of colonoscopy in the diagnosis of colonic diseases. Methods The clinical data of 871 patients after colonoseopy in our unit with single abdominal symptom were analyzed retrospectively, and according to the single symptom , patients were derided into four groups , namely abdominal pain group, diarrhea group, constipation group or rectal bleeding group. Results In abdominal pain group , the detection rate of colonic polyps and cancer were 14. 66% ,4. 02% respectively, the detection rate in diarrhea group were 14. 86% ,4.05% respectively,and in constipation group were 17. 54% ,5.26% respectively, however in rectal bleeding group were 18.58% ,25.66% respectively, there is no significantly difference of the detection rate of colonic polyps between four different groups （ P 〉 0. 05 ）. The most frequent symptom was rectal bleeding, and the detection rate of colorectal cancer in rectal bleeding group was significantly higher than those three groups（ P 〈 0. 05 ）. There is no significantly difference the male cotorectal cancer patients and the female＇ s （ P 〉 0. 05 ）. The detection rate of colorectal cancer was increased along with age. The Tumors and polyps lie in left colon more frequent than those in right colon. Conclusion Rectal bleeding is alarm symptoms in early diagnosis of eolorectal cancer. The indication of colonoscopy test to the elderly should be broader and the whole colon must be tested.