社区糖尿病患者大肠癌筛查结果分析  

Screening Results Analysis of Colorectal Cancer in Diabetic Patients in Communities

作　　者：杨军花 张玮 杨安卿[2] 秦征魏 刘岩 花云 华红梅 郭稀 YANG Junhua;ZHANG Wei;YANG Anqing;QIN Zhengwei;LIU Yan;HUA Yun;HUA Hongmei;GUO Xi(Baiyu Community Health Service Center,Shanghai 200063,China;Luwan Branch,Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海市白玉社区卫生服务中心,200063 [2]上海交通大学医学院附属瑞金医院卢湾分院,上海市200025

出　　处：《中国全科医学》2020年第6期662-666,共5页Chinese General Practice

基　　金：上海市普陀区卫生系统自主创新科研资助项目（社区项目2018-10）

摘　　要：背景随着现代生活方式的改变,糖尿病和大肠癌发病率均呈逐渐上升趋势。糖尿病与大肠癌的相关性研究证明,糖尿病是大肠癌的高危因素,该人群应定期进行大肠癌筛查。目的分析糖尿病患者参与大肠癌筛查的结果,为今后社区糖尿病慢性病管理工作提供更多的技术参考。方法选取2016-2018年上海市白玉社区卫生服务中心所辖社区中参与大肠癌筛查的糖尿病患者319例,研究初期发放两份调查问卷表,一份是基于体检要求本中心自行设计的健康体检表,主要调查参与筛查的居民有无确诊糖尿病史。另一份为上海市大肠癌筛查项目组统一编制的《上海市社区居民大肠癌筛查危险度评估表》,内容包括基本情况(性别、年龄、婚姻状况、文化程度、职业)、大肠癌危险因素(慢性腹泻史、慢性便秘史、黏液血便史、慢性阑尾炎或阑尾切除史、慢性胆囊炎或胆囊切除史、肠息肉史、血吸虫病史、癌症史、一级亲属肿瘤史、精神创伤史),记录初筛结果(便隐血试验阳性、危险度评估阳性,任一阳性为初筛阳性)。研究后期针对初筛阳性者发放本中心自行编制的调查问卷表,内容包括是否行肠镜检查、肠镜检查结果、对肠镜检查相关认知(对肠镜检查害怕、认为自己不会有问题、担心检查后出现不适后果、担心查出问题有心理负担、没时间没兴趣、肠镜检查有益处)。结果 319例患者年龄以60~69岁居多(45.8%),婚姻状况以已婚为主(91.2%),文化程度以中专/中学为主(57.1%),职业以国有企业为主(39.8%)。大肠癌危险因素以慢性阑尾炎或阑尾切除史、肠息肉史、慢性胆囊炎或胆囊切除史占比较高,分别为14.7%、13.8%、13.5%。便隐血试验阳性率6.6%(21/319),危险度评估阳性率18.2%(58/319),双阳性率6.0%(19/319)。79例初筛阳性患者中,有23例进行了肠镜检查,其中无病变者占39.1%、肠炎者占26.1%、息肉Background With the changes in modern lifestyles,the incidence of diabetes and colorectal cancer is increasing gradually.The study of the relationship between diabetes and colorectal cancer proves that diabetes is a high risk factor for colorectal cancer,and regular screening for colorectal cancer should be noted.Objective To analyze the results of patients with diabetes mellitus participating in colorectal cancer screening,and provide more technical references for the management of chronic diseases in community diabetes in the future.Methods 319 diabetic patients who participated in colorectal cancer screening in communities under the jurisdiction of Shanghai Baiyu community health service center from 2016 to 2018 were selected.Two questionnaires were issued at the beginning of the study.One was a health checklist designed by the center based on the requirements of the medical examination.The main purpose was to investigate whether the residents who participated in the screening had a history of diabetes mellitus.Another Shanghai Community Residents Colorectal Cancer Screening Risk Assessment Form prepared for screening for colorectal cancer in Shanghai included basic information(gender,age,marital status,education level,occupation) and risk factors of colorectal cancer(chronic diarrhea,history of chronic constipation,history of mucus and bloody stool,history of chronic appendicitis or appendectomy,history of chronic cholecystitis or cholecystectomy,history of intestinal polyps,history of schistosomiasis,history of cancer,history of first-degree relatives with cancer,history of trauma) and primary screening results(positive occult blood test,positive risk assessment,and any positive results for primary screening).In the later stage of the study,the questionnaires prepared by the center were distributed,its content included whether to have colonoscopy,colonoscopy results,and recognition related to colonoscopy(fear of colonoscopy,thinking that there will be no problem and worrying about the uncomfortable consequen

关 键 词：糖尿病 肠肿瘤 社区卫生中心 筛查 

分 类 号：R587.1[医药卫生—内分泌]