老年人与中青年人大肠息肉的临床特点及内镜下治疗的比较研究

目的比较老年人与中青年人大肠息肉的临床特点及内镜下治疗。方法本研究选取经电子结肠镜检查后确诊的153例结肠息肉并行内镜下息肉切除的患者,其中老年组(年龄≥60岁)71例,检出息肉共275枚,中青年组(年龄<60岁)82例,检出息肉共396枚。回顾性分析并比较老年组和中青年组的性别、合并疾病、息肉数量、部位、形态、病理类型、手术方法、平均住院时间及术后并发症。结果老年组和中青年组的大肠息肉好发于男性,且中青年组男性息肉比例(70.7%)高于老年组(53.5%);老年组具有合并症的患者高于中青年组(47.9%vs 25.6%,P<0.05)。中青年组左半结肠息肉比例大于老年组(65.9%vs 45.5%,P<0.05);老年组直径在1.0-2.0 cm之间的息肉枚数及山田Ⅲ型息肉枚数明显高于中青年组;两组患者腺瘤性息肉的发生率明显高于其他病理类型息肉,尤其以管状腺瘤为高发。两组患者的内镜下息肉切除方式、术后并发症及平均住院时间比较无统计学差异。结论老年人和中青年的大肠息肉具有各自的特点,因而在行内镜下息肉切除时需要选择具有针对性的治疗方案。

Comparative study on the clinical features of colorectal polyps and endoscopic treatment between elderly and young patients

Objective To compare the clinical characteristics and endoscopic treatment for colorectal polyps between the elderly and the young patients.Methods A total of 153 cases of colon polyps confirmed by the electronic colonoscopy were enrolled,and divided into two groups:elderly group(age≥60 years,n=71) and young group(age<60 years,n=82).The sex,comorbidities,polyp number,location,morphology,pathological types,surgical method,mean hospitalized days and postoperative complications were retrospectively analyzed and compared between 2 groups.Results A total of 275 and 396 polyps were detected in elderly group and young group,respectively.The colorectal polyps occurred in males more than females in two groups.The proportion of male in young group (70.7%) was higher than that in elderly group(53.5%).The incidence of complications was higher in elderly group than that in young group(47.9% vs 25.6%,P<0.05).And the incidence of left colon polyps was higher in young group than that in elderly group(65.9% vs 45.5%,P<0.05).The incidence of polyps with diameter 1.0-2.0 cm and Yamada III in elderly group were significantly higher than those in young group(P<0.05).The incidence of adenomatous polyps was significantly higher than those of other histological types of polyps in elderly group and young group,particularly the tubular gland tumor.There was no significant difference between two groups in the endoscopic polypectomy resection,postoperative complications and the average hospitalized days. Conclusion The clinical characteristics are different in elderly and young patients.For different age patients,a targeted endoscopic treatment should be chosen by clinicians.