结肠镜检查5690例患者的适应证及疾病分布特征  

Indications for colonoscopy examination and its disease distribution:a report of 5690 cases

作　　者：金黑鹰[1] 叶辉[1] 吴崑岚[1] 朱勇[1] 张金浩[1] 刘萍[1] 张铁娥[1] 丁义江[1] 

机构地区：[1]南京中医药大学第三附属医院全国肛肠医疗中心南京中医药大学中西医结合专业博士后流动站,210001

出　　处：《中华胃肠外科杂志》2006年第3期214-216,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨结肠镜检查与各适应证对应的疾病分布。方法回顾性分析2000年1月至2004年12月间进行的5690例结肠镜检查患者的检查结果。结果男性3096例,女性2594例;年龄(52±15)岁。患者进行结肠镜检查的原因:26.9%为便血;25.8%为不典型腹部疼痛;11.1%为腹泻、大便次数增多或大便不成形;7.6%为肛门坠胀、疼痛不适;7.0%为便秘;3.0%为排黏液或脓血便;0.9%为体检发现直肠肿块和腹部包块;10.9%为结肠镜息肉摘除术后复查;1.5%为结直肠癌术后复查;2.2%为单纯体检者;其余3.1%为其他原因进行检查者。结肠镜到达回盲部的比例为97.7%,共发现各种疾病2283例(40.1%)。其中结直肠癌10.3%,结直肠息肉19.6%,溃疡性结肠炎4.3%,克罗恩病0.5%。结论应对出现便血、非特异性腹痛、腹泻或便秘者和结直肠癌术后、结直肠息肉及结直肠癌遗传受累者进行定期的结肠镜检查。Objective To explore the indications for colonoscopy examination and the distribution of diagnostic diseases. Method From Jan. 2000 to Dec. 2004, 5960 patients received colonoscopy examination in our colorectal center. The indications for colonoscopy examination and the distribution of its diagnostic diseases were analyzed. Results There were 3096 males and 2594 females, and the mean age was （52± 15） years. The reasons for colonoscopy included hemafecia（26. 9% ）, atypical abdominal pain （25.8%）, diarrhea or increased frequency of stool（11.1% ）, anal tenesmns or discomfort（7.6% ）, constipation（7.0% ）, mucous or bloody purulent stool（3.0% ）, intra-rectal mass or abdominal mass on physical examination（0. 9% ）, re-examination after colonoscopic polypectomy（ 10. 9% ）, re-examination after operation for colorectal cancer（ 1.5% ）, simple health examination（2. 2% ）. Colonoscope reached the cecum in 97.7% of the cases, and at least one disease was found in 2283 cases（40. 1% ）. Among them, colorectal cancer accounted for 10. 3%, colorectal polyps 19.6%, ulcerative colitis 4. 3%, and Crohn＇s disease 0. 5% respectively. Conclusion The indications for colonoscopy are too strict to screen the early stage colorectal cancer. Colonoscopy should be performed in the cases with symptoms such as bloody stool, diarrhea, abdominal pain, constipation, or with colorectal polyps, after operation for colorectal cancer, or as members of hereditary colorectal cancer family.

关 键 词：结肠镜 适应证 结直肠肿瘤 早期诊断 

分 类 号：R574.62[医药卫生—消化系统] R51[医药卫生—内科学]