不同类型胃息肉临床病理特征及术后复发危险因素分析  

Analysis of clinicopathological characteristics and risk factors for recurrence of different types of gastric polyps

作　　者：李晓芳[1] 徐俊荣[1] 牛健[2] 

机构地区：[1]西安市中心医院消化科,陕西西安710003 [2]西安市中心医院病理科,陕西西安710003

出　　处：《胃肠病学和肝病学杂志》2016年第10期1156-1160,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的 探讨不同类型胃息肉的临床病理特征并对术后复发危险因素进行分析。方法 对西安市中心医院2010年3月-2015年3月收治的1 965例住院胃息肉患者临床资料和其中524例接受内镜治疗患者36个月内复查结果进行回顾性分析,总结胃息肉的病理炎症特点,并对胃息肉术后复发危险因素进行分析。结果 女性患者患增生性息肉和炎性息肉的比率明显高于男性（P〈0.05）,胃底腺息肉、增生性息肉、腺瘤性息肉及炎性息肉的发病率均随着年龄增长而增加,差异均具有统计学意义（P〈0.05）。胃底腺息肉和腺瘤性息肉的发病率与性别无相关性（P〉0.05）。胃底腺息肉最多见于胃底,增生性息肉多见于胃体部位,差异具有统计学意义（P〈0.05）。χ~2检验结果显示腺瘤性息肉与增生性息肉的幽门螺杆菌（Helicobacter pylori,H.pylori）感染率显著高于胃底腺息肉和炎性息肉（P〈0.05）。985例胃息肉患者在接受内镜治疗后均恢复良好,无术后严重并发症出现。对其中524例内镜治疗患者进行定期随访复查,168例于术后36个月内复发,Logistic回归分析结果显示,年龄、息肉大小、息肉数量、H.pylori感染和息肉类型为胃息肉术后复发的危险因素。结论 对胃息肉的临床、内镜及病理特点的分析有助于胃镜检查对胃息肉性质的初步判断。另外,内镜下治疗胃息肉安全、有效,但年龄〉45岁、息肉数量为胃多发息肉、息肉直径〉1 cm、息肉类型为腺瘤性的患者术后较易复发,须注意术后定期复查。Objective To investigate the clinicopathological characteristics and risk factors for recurrence of different types of gastric polyps. Methods Clinical data of 1 965 hospitalized gastric polyps and follow-up review of 524 patients with endoscopic treatment in Xi＇ an Central Hospital from Mar. 2010 to Mar. 2015 were retrospectively analyzed. The characteristics of pathological inflammation of gastric polyps were summarized, the risk factors for recurrence of stomach polyp were analyzed. Results The incidences of hyperplastic polyps and inflammatory polyps in females were signifi- cantly higher than those in males （ P 〈 0.05 ）. Incidences of fundic gland polyps, hyperplastic polyps, adenomatous pol- yps and inflammatory polyps increased with age, the difference was statistically significance （P 〈 0.05 ）. The gender was not related with fundic gland polyps and adenomatous polyps（P 〉0.05）. Gastric fundic gland polyps were seen in stomach bottom. Hyperplastic polyps were found in most parts of gastric body, the difference was statistically significant （P 〈 0.05）. Chi-square test analysis showed that infection rates of Heltcobacter pylori （H. pylori） in adenomatous pol- yps and hyperplastic polyps were significantly higher than those in fundic gland polyps and inflammatory polyps （P 〈 0.05）. Nine hundred and eight-five cases of gastric polyp patients receiving endoscopic treatment recovered well. For 524 cases with a 36-month follow-up, there were 168 cases recurrence within 36 months. Logistic regression analysis showed that age, infection of H. pylori, multiple polyp, size of the the poly and pathological types were the risk factors for recurrence of the gastric polyps. Conclusion The clinical gastric polyps, endoscopic and pathological features analy- sis can help endoscopy preliminary judgment on the nature of gastric polyps. In addition, endoscopic treatment of gastric polyps is safe and effective, but patients who were older than 45 years old, with H. pylori infection, multiple

关 键 词：胃息肉 病理类型 复发 危险因素 

分 类 号：R573[医药卫生—消化系统]