老年人大肠息肉200例诊治分析

目的探讨老年人大肠息肉的临床特点及流行病学、内镜下大肠息肉分布、病理特点和内镜治疗过程中的注意事项及特点。方法回顾性分析内镜电凝电切术、钳切术或套扎术治疗的200例老年人大肠息肉患者的有关资料及病理结果。结果老年人大肠息肉男女比为2.5∶1,平均66.2岁,内镜检出率23.5%。临床表现为腹痛占42.0%,便血占18.5%;息肉单发者占57.0%,多发者占43.02%;息肉形态山田Ⅰ型占71.38%;息肉直径〈0.5cm占76.5%,〉2.1cm占1.6%;息肉分布在左半结肠占61.6%,其中乙状结肠占34.4%,直肠占27.1%;腺瘤性息肉占83.29%,炎症性息肉占4.83%,增生性息肉占11.46%,大肠腺瘤性恶变率为0.48%。结论息肉的分布主要在左半结肠,以腺瘤性息肉为主,恶变者主要为腺瘤性,但发生率较低。内镜下行高频电凝电切术最好行心电监护,定期内镜检查治疗为预防其癌变的有效措施。

Treatment analysis of large intestine polyp in 200 aged people

Objective To explore the clinic characteristic and epidemiology distribution under endoscope and pathological features and cautions and features through endoscopic management.Methods The informations and pathological results were retrospective analyzed by endoscopic electric coagulation and using forceps technigue or endoscopic variceal ligation（EVL）in 200 aged people.Results Male/Female ratio was 2.5∶1 of large intestine polyp in aged people,average age was 66.2 years old.The detectable rate with gastroscopy was 23.5%.The clinical manifestations were abdominal pain（42.0%）,hematochezia（18.5%）,solitary polypus（57.0%）,multiple polypus（53%）.ShanTian Ⅰtype accounted for 71.38% of polypus shapes.The diameter of polypus was less than 0.5cm accounted for 76.5%,and that of greater than 2.1 cm accounted for 1.6%.The polypus was distributing mainly over left colon（61.6%）,in which sigmoid flexure accounted for 34.4%,rectum 27.1%,adenomatoid polyps 83.29%,inflammatory polyps 4.83%,hyperplastic polyps 11.46%.The malignancy changing rate of large intestine was 0.48%.Conclusion The distribution was mainly over left colon,and adenomatoid polyp was priority and mostly led to canceration,but the incidence was lower.Therapeutic process under endoscope should be paid attention to physiological and pathological features,and cardiac monitoring was required through electric coagulation.The endoscopic diagnosis and therapy at regular intervals was effective measures to prevent canceration.