便血患者1193例的常见病因及其与年龄的相关性  

Relationship between aetiology and age in 1193 patients with hematochezia

作　　者：刘懿[1] 王磊[1] 张志军[1] 钱立平[1] 钟良[1] 

机构地区：[1]复旦大学附属华山医院消化科,上海200040

出　　处：《上海医学》2007年第10期751-753,共3页Shanghai Medical Journal

摘　　要：目的探讨便血患者的常见病因及其与年龄的相关性。方法分析我院2001年1月至2005年10月诊治的1193例便血患者的肠镜或双气囊小肠镜检查结果。结果①便血患者的常见病因依次为结肠息肉(25.15%),直肠和结肠癌(13.75%),直肠和结肠炎症(10.65%),溃疡性结肠炎(5.11%),憩室病(2.51%),内痔(2.26%),血管发育不良(1.76%)。②结肠息肉(R=0.79,95%CI为0.02～0.06)、直肠和结肠癌(R=0.94,95%CI为0.03～0.05)、憩室(R=0.69,95%CI为0.00～0.02)、血管发育不良(R=0.65,95%CI为0.00～0.02)与年龄呈正相关(P值分别<0.05、0.01)。溃疡性结肠炎(R=0.90,95%CI为—0.03～0.01)与年龄呈负相关(P=0.00)。直肠和结肠炎症、内痔与年龄不相关(P值均>0.05)。结肠和直肠癌与息肉的发生率无显著关联(x^2=0.25,P=0.62)。结论结肠息肉、直肠和结肠癌、直肠和结肠炎症、溃疡性结肠炎、憩室病、内痔及血管发育不良均为便血的主要病因;随着年龄的增长,结肠息肉、直肠和结肠癌、憩室病及血管发育不良所致出血的发生率呈增长趋势,而溃疡性结肠炎所致出血的发生率随着年龄的增长呈下降趋势。结肠和直肠癌发生率与息肉发生率无显著关联。Objective To study the aetiology of hematochezia and its relationship with age. Methods A total of 1193 patients with hematochezia received colonoscopy or double-balloon enteroscopy in our hospital from January 2001 to October 2005. The age of the patients ranged from 14 to 97 years old and they were allocated into 8 age groups. Results It was found that the main causes of hematochezia were as follows： colorectal polyps （300 cases, 25.15%）, colorectal cancer （164 cases, 13.75%）, colitis （127 cases, 10.65%）, ulcerative colitis （61 cases, 5.11%）, diverticulosis （30 cases, 2. 51%）, internal hemorrhoid （27 cases, 2. 26%） and vascular maldevelopment （21 cases, 1.76%）. Colorectal polyps （R = 0.79, 95% CI = 0. 02-0. 06） , colorectal cancer （R = 0.94, 95%CI = 0. 03-0. 05） , diverticulosis （R = 0.69, 95 %CI = 0.00 - 0.02）, and vascular maldevelopment （R = 0.65, 95 %CI = 0. 00 - 0.02） were positively correlated with age; ulcerative colitis was negatively correlated with age （R = 0.90, 95 % CI =- 0.03 - 0.01） colitis was not correlated with age （P 〉 0.05） ; and colorectal cancer was not correlated with colorectal polyps （x^2 = 0.25, P = 0.62）. Condusion Colorectal polyps, colorectal carcinoma, colitis, ulcerative colitis, diverticulosis internal hemorrhoid, and vascular maldevelopment are the main causes of hematochezia. Colorectal polyps, colorectal carcinoma, diverticulus and angiodysplasia are positively correlated with age increase; ulcerative colitis is negatively correlated with age increase; and colorectal cancer is not correlated with colorectal polyps. （Shanghai Med J, 2007, 30：751-753）

关 键 词：便血 结肠镜检查 发生率 

分 类 号：R574.9[医药卫生—消化系统]