结直肠癌临床表现对及时诊断的影响  

Clinical manifestations of colorectal cancer and its influence in prompt diagnosis

作　　者：杨文[1] 于晓红[1] 杨志健[1] 黄学飞[1] 刘静[1] 李丛勇 

机构地区：[1]中国人民解放军海军总医院干部病房消化内科,北京市100048

出　　处：《实用老年医学》2016年第2期158-161,共4页Practical Geriatrics

摘　　要：目的探讨结直肠癌临床表现和诊断延误的关系。方法回顾性分析了151例经组织学证实为结直肠癌患者的临床资料，并以出现临床表现到明确诊断时间的长短分为〈1月，1～3月和〉3月3组，比较3组之间的年龄、性别、肿瘤分期、肿瘤位置和临床症状的差异。结果贫血、大便潜血阳性，腹部疼痛在结直肠癌患者中的发生率均〉60％；3组闻年龄、大便潜血试验阳性、大便带血、腹胀、恶心、腹痛、便秘或腹泻和乏力差异有统计学意义（P〈0．01），性别、肿瘤位置及分期在3组间差异无统计学意义（P〉0．05）；肿瘤位于降结肠，乙状结肠和直肠的患者更容易出现便血和便秘和（或）腹泻（P〈0．01），而肿瘤位于回盲部、升结肠和横结肠者更容易出现贫血（P〈0．01）；不同肿瘤分期之间临床表现差异无统计学意义（P〉0．05）。结论贫血、大便潜血阳性、腹痛、便血、便秘和（或）腹泻是结直肠癌最常见的症状。粪便潜血阳性、腹痛、便秘和（或）腹泻往往与延误诊断相关，贫血与右侧结肠癌相关，大便带血、便秘和（或）腹泻与左侧结直肠癌相关。Objective To identify clinical factors associated with delayed diagnosis for patients with colorectal cancer. Methods Clinical characteristic were retrospectively collected for patients with a histological proven diagnosis of colorectal cancer. Patients were divided into three groups by the length of time from clinical manifestations onset to diagnosis：〈 1 month,1 - 3 months and 〉3 months groups. Clinical data were compared within three groups. Results The most common clinical manifestations were anemia,fecal occult blood positive,abdominal pain,presented in 60% of patients with colorectal cancer. Age,incidence of fecal occult blood positive,blood in or on stool,abdominal distension,nausea,abdominal pain,constipation or diarrhea and fatigue were significantly different among three groups（ P〈0. 01）.There were no significant differences among three groups for gender and tumor location（ P〉0. 05）. Patients with left-sided colorectal cancer were more easily presented with blood in or on stool（ P〈0. 01） and constipation or diarrhea（ P〈0. 01）;Patients with right-sided were more easily presented with anemia（ P〉0. 01）. Tumor stage was not significantly related to clinical symptoms（ P〉0. 05）. Conclusions Anemia,fecal occult blood positive,abdominal pain,blood in or on stool,and constipation or diarrhea are the most frequent clinical manifestations for patients of colorectal cancer. Patients with fecal occult blood positive,abdominal pain and constipation or diarrhea tend to be having long time from clinical manifestations onset to diagnosis. Blood in or on stool and constipation or diarrhea are associated with left-sided colorectal cancer whereas anemia associated with right-sided.

关 键 词：结直肠癌 症状 诊断 

分 类 号：R735.35[医药卫生—肿瘤]