成人结肠镜在小儿出血性结直肠息肉诊治中的应用  

Application of Adult Colonoscope for Examination and Treatment in Pediatric Hemorrhagic Colorectal Polyps

作　　者：刘宇虎[1] 张志坚[1] 程树红[1] 傅莉萍[1] 陈孟君[1] 黄妙兴[1] 马庆峰[1] 李兴谦[1] 

机构地区：[1]广东省东莞市人民医院,广东东莞523059

出　　处：《中国医学创新》2012年第27期96-98,共3页Medical Innovation of China

基　　金：东莞市科技计划项目(编号:201110515000312)

摘　　要：目的:探讨成人结肠镜在小儿出血性结直肠息肉诊治中的应用价值。方法:对便血患儿进行成人肠镜检查并电切除治疗息肉,分析息肉的临床表现、镜下形态、病理特点,评估其安全性。结果:85%便血患儿发现结直肠息肉,临床症状主要为便血(35/35),腹痛(5/35),肛门有肿物脱出(9/35),粪便表面可见沟槽(6/35),直肠指检可触及肿块(8/35)。35例患儿发现息肉共38颗,单发占91.4%(32/35),多发3例,大小多数在2cm左右。息肉主要在直肠占73.7%(28/38),在直肠和乙状结肠共占92.1%(35/38)。息肉均在肠镜下成功微创电切治疗,术中、术后无肠出血、肠穿孔并发症,电切成功率为100%。息肉病理检查,多数为幼年性息肉占73.7%(28/38),少数为增生性息肉占15.8%(6/38)和炎性息肉占10.5%(4/38)。术后未再便血。结论:结直肠息肉是小儿便血的最常见原因,息肉主要在直肠和乙状结肠,多为单发,病理以幼年性息肉为主,电切息肉后未再便血。成人结肠镜对小儿出血性结直肠息肉的检查和微创电切治疗是安全有效的。Objective ： To explore the value of application of adult colonoscope for examination and treatment in pediatric hemorrhagic colorectal polyps. Method： The pediatric patients presented with hematochezia were examined and treated by adult colonoscope, and analyzed the clinical manifestation, endoscopic appearance, pathological character of pediatric coloreetal polyps. To evaluate the security of adult colonoseope for examination and treatment in pediatric hemorrhagic colorectal polyps. Result： The colorectal polyps were found out in 85% hemorrhagic children and determined the presence, number, and location of colorectal polyps. 38 polyps irt 35 cases were treated by endoscopic high-frequency electroresection. The majority of those bleeding polyps were in the rectum 73.7%（28/38）, in the reetosigmoid 92.1%（35/38）. Most of the polyps were single 91.4%（32/35） and about 2 cm in diameter. All 38 polyps were successfuUy resected completely after endoscopic polypectomy with minimally invasive surgery. No complications of bleeding and perforation happened in these children. The achievement ratio of polypectomy was 100%. Pathological results showed that the most frequent type was juvenile polyps 73.7%（28/38）, few were hyperplastic polyps 15.8%（6/38） and inflammatory polyps 10.5%（4/38）. It was not bleeding again after endoscopic polypectomy. Conclusion： The most frequently cause of pediatric bleeding in lower digestive tract is coloreetal polyp, most polyps are in rectum and sigmoid colon, and single, and the most frequent type is juvenile polyp. It is an effective and safety method for pediatric hemorrhagic colorectal polyps of endoscopic detection and polypectomy by adult eolonoscope.

关 键 词：结肠镜 电切 小儿结直肠息肉 

分 类 号：R735.3[医药卫生—肿瘤]