摘要
背景:通过结肠镜检查发现并治疗结直肠息肉,对结直肠癌的预防至关重要。目的:分析结肠镜检查者的临床症状对结直肠息肉和癌的提示作用,为结肠镜筛查受检者的选择提供参考。方法:2366例接受结肠镜检查者纳入研究,采集其就诊时症状、病变部位、病变性质等信息,分析结直肠息肉和癌的检出率以及不同临床症状与疾病风险和病变部位的相关性。结果2 366例受检者中,结直肠息肉和癌的检出率分别为20.5%和5.4%,有临床症状者检出率显著高于无症状者(息肉:24.2%对4.5%,癌:6.4%对0.9%,P均=0.000)。以腹泻(OR=1.213)、便血(OR=2.076)、粪便性状改变(OR=1.503)为首要症状者的结直肠息肉检出率显著增高(P均<0.05),以腹痛(OR=1.568)、便血(OR=2.837)、粪便性状改变(OR=2.206)、里急后重感(OR=1.735)为首要症状者的结直肠癌检出率显著增高(P均<0.05)。以便血、粪便性状改变、里急后重感为首要症状者病变主要分布于直肠或左半结肠(P均<0.05)。结论:腹泻、便血、粪便性状改变与结直肠息肉风险有关,腹痛、便血、粪便性状改变、里急后重感与结直肠癌风险有关,对有上述症状者强烈推荐行结肠镜检查。
Background：Detection and removal of colorectal polyp by colonoscopy is of great importance for prevention of colorectal carcinoma. Aims：To investigate whether the clinical symptoms of patients undergoing colonoscopy may hint colorectal polyp and carcinoma,and provide reference for candidate selection in colonoscopic screening. Methods：A total of 2 366 patients undergoing colonoscopy were recruited and the history information such as symptoms at outpatient visits, site and nature of the lesions was collected for analyzing the detection rates of colorectal polyp and carcinoma and the correlations of clinical symptoms with the risk and site of the disease. Results：The overall detection rates of colorectal polyp and carcinoma were 20. 5% and 5. 4% ,respectively,in 2 366 patients. The detection rates were significantly higher in symptomatic patients than those in asymptomatic patients（24. 2% vs. 4. 5% for polyp and 6. 4% vs. 0. 9% for carcinoma,P all = 0. 000）. Moreover,when patients were classified by major symptoms,the detection rate of colorectal polyp was significantly increased in patients with diarrhea（OR = 1. 213）,hematochezia（OR = 2. 076）,and changing of stool consistency（OR = 1. 503）（P all〈 0. 05）,and the detection rate of colorectal carcinoma was significantly increased in patients with abdominal pain（ OR = 1. 568）,hematochezia（ OR = 2. 837）,changing of stool consistency（ OR =2. 206）,and tenesmus（ OR = 1. 735）（ P all〈 0. 05）. The major symptoms being hematochezia,changing of stool consistency and tenesmus were associated with lesions locating at rectum or left hemicolon（P all〈 0. 05）. Conclusions：Diarrhea, hematochezia and changing of stool consistency hints risk for colorectal polyp, while abdominal pain, hematochezia,changing of stool consistency and tenesmus hints risk for colorectal carcinoma. Colonoscopy is strongly recommended for patients with these symptoms.
出处
《胃肠病学》
2015年第10期612-615,共4页
Chinese Journal of Gastroenterology
基金
秦皇岛市科技计划项目(201401A275)
关键词
结直肠肿瘤
肠息肉
体征和症状
结肠镜检查
诊断
Colorectal Neoplasms
Intestinal Polyps
Signs and Symptoms
Colonoscopy
Diagnosis
