门诊结直肠微小息肉治疗策略的回顾性研究  

A retrospective study on treatment strategy for outpatient diminutive colorectal polyps

作　　者：邓雪瑜 徐杨[1] DENG Xueyu;XU Yang(Department of Gastroenterology,Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院消化内科

出　　处：《中南大学学报（医学版）》2019年第10期1169-1173,共5页Journal of Central South University ：Medical Science

摘　　要：目的:探讨门诊结直肠微小息肉的治疗策略。方法:回顾性收集2012年1月到2014年12月在中南大学湘雅二医院门诊内镜中心行结肠镜检查时首次发现结直肠微小(直径≤5 mm)息肉的病例。分析首次未予切除的自然病程组(A组,n=31)的线性增长率和首次发现即行切除的术后随访组(B组,n=212)的复发率;比较两组患者随访前后的腺瘤检出率、进展期腺瘤发生率、癌变发生率等。结果:随访时间为1.5~57.6个月。在A组病例中,61.2%的患者线性直径维持稳定,19.4%的患者呈线性进展,线性进展在12.1~24.0个月内最高,为25.0%。B组病例复发率为16%,首次随访复发率最高的随访间期为12.1~24.0个月,占14.3%。A组和B组患者腺瘤检出率分别为38.7%和54.2%。在A组中,3.2%的患者自然进展为进展期腺瘤,在B组中,1.4%的患者复发进展为进展期腺瘤。两组均未发现癌变患者。结论:门诊结肠镜检查发现的结直肠微小息肉可选择暂不切除,追踪复查结肠镜时间以12~24个月为宜。Objective:To discuss the treatment strategy for outpatient diminutive colorectal polyps.Methods:Diminutive colonic polyps(≤5 mm in size)patients detected at the initial screening colonoscopy between January 2012 to December 2014 at outpatient endoscopy center of the Second Xiangya Hospital were retrospectively studied.Th e linear growth rate of the natural history cases without polypectomy(Group A,n=31)and the recurrence rate aft er polypectomy(Group B,n=212)were analyzed.Th en the adenoma detection rate,the incidence of advanced adenoma and cancer were compared between the 2 groups.Results:Patients were followed up for 1.5–57.6 months.In the Group A,61.2%patients’linear diameter remained stable and 19.4%patients were progressed.Th e growth rate in 12.1–24.0 months were the highest(25.0%).In the Group B,overall recurrence rate was 16%aft er polypectomy in the Group B.Th e highest recurrence rate for the fi rst follow-up was 12.1–24.0 months,accounting for 14.3%.The adenoma detection rates in the Group A and the Group B were 38.7%and 54.2%,respectively.In the Group A,3.2%of patients naturally progressed to advanced adenoma,and 1.4%of patients in the Group B relapsed into advanced adenoma.No cancerous patients were found in either group.Conclusion:Outpatient diminutive colorectal polyps can be temporarily unremoved for colonoscopy screening.It is advisable to perform colonoscopy within 12–24 months.

关 键 词：结直肠微小息肉 自然病程 术后随访 线性增长率 进展期腺瘤 结直肠息肉癌变 

分 类 号：R73[医药卫生—肿瘤]