结肠腺瘤高频电凝切除术术后复发情况分析  

Colon adenoma recurrence after endoscopic high-frequency electric polypectomy

作　　者：张黎明[1] 刘玉兰[1] 朱元民[1] 杨静[1] 

机构地区：[1]北京大学人民医院消化科,北京100044

出　　处：《中华消化内镜杂志》2012年第8期429-432,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的了解结肠腺瘤患者行电凝切除术后的复发情况。方法2000年至2008年行结肠息肉高频电凝切除术且符合入选标准者283例，根据患者基线肠镜时的病史及结肠镜检查发现的结肠腺瘤特征进行分析，计算患者0～2年、〉2～5年及〉5～8年累积复发率，中位复发时间及影响复发的因素。结果所有观察病例中，0～2年累积复发率为61％，〉2～5年累积复发率为81％，〉5～8年累积复发率为84％。COX回归分析发现，性别、年龄、是否有非结肠肿瘤史、饮酒史以及初检腺瘤是否为多发（〉2个）是影响腺瘤复发的主要因素。结论在中国人群中，行结肠腺瘤高频电切术的患者建议术后2年复查1次肠镜。对于年龄〉60岁的男性患者，如结肠腺瘤为多发，建议20个月左右复查1次结肠镜，如同时存在非结肠肿瘤病史或饮酒史，建议进一步缩短复查时间。Objective To study the recurrence of colon adenoma after endoscopic high-frequency e- lectric polypectomy. Methods The data of 238 patients undergoing endoscopic polypectomy between 2000 and 2008 were retrospectively analyzed. The cumulative recurrence rates at 0-2 years, 〉 2-5 years and 〉 5- 8 years after polypectomy, median recurrence time and main risk factors for recurrence were identified based on the features of adenomas detected on initial colonoscopy. Results The cumulative recurrence rates of ad- enoma at the surveillance examination were 61% , 81% , and 84% for the three intervals, respectively. On multivariate analysis, gender, age, extra-colonic tumor history, alcohol drinking history and adenoma num- ber at initial examination were the independent risk factors of adenoma recurrence. Conclusion We suggest a 2-year surveillance interval for Chinese patients with colonic adenoma after the initial endoscopic polypecto- my, a 20-month surveillance interval for males over 60 years old who have more than 2 adenomas at the ini- tial eolonoscopy, and an even shorter interval for those with extra-colonic tumor history or alcohol drinking history.

关 键 词：腺瘤性息肉 结肠 电凝术 复发 结肠镜 

分 类 号：R735.3[医药卫生—肿瘤]