儿童结直肠息肉1 351例的临床特征及内镜下治疗效果分析  

Clinical features of children with colorectal polyps and the efficacy of endoscopic treatment: an analysis of 1 351 cases

作　　者：刘波[1] 张慧华 张慧晖 方浩然 胡华建[1] 李中跃[1] LIU Bo;ZHANG Hui-Hua;ZHANG Hui-Hui;FANG Hao-Ran;HU Hua-Jian;LI Zhong-Yue(Department of Gastroenterology/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics/Children's Hospital of Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院消化科/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室,重庆400014

出　　处：《中国当代儿科杂志》2022年第4期354-359,共6页Chinese Journal of Contemporary Pediatrics

摘　　要：目的 探讨儿童结直肠息肉的临床特征及内镜下治疗的效果。方法 回顾性分析近8年收治的经结肠镜检查并治疗的结直肠息肉1 351例患儿的临床特征和内镜下治疗的方式和效果。结果 1 351例患儿中,男性多见(893,66.10%),高发年龄2~<7岁(981,72.61%),临床表现以便血(1 307,96.74%)为主;89.27%(1 206/1 351)为单发息肉,95.77%(1 290/1 347)为幼年性息肉。息肉均采用热活检钳电灼烧(6例)或圈套器套扎后通过高频电切电凝(1 345例)的方式切除。共切除息肉1 758枚,其中有蒂息肉占90.61%(1 593/1 758),直径<2 cm的息肉占76.73%(1 349/1 758)。术后并发症:出血51例(3.77%),呕吐87例(6.44%),腹痛14例(1.04%),发热39例(2.89%),无一例穿孔。年龄<3岁患儿术后出血和发热的发生率高(P<0.0125);单发息肉直径≥2 cm患儿术后出血、呕吐、发热的发生率高(P<0.05)。结论 儿童结直肠息肉以单发、有蒂、幼年性息肉为主。采用热活检钳电灼烧或圈套器套扎后高频电切电凝的方式能有效切除儿童结直肠息肉,效果好,并发症少。患儿年龄越小、息肉直径越大,术后出血风险越高。Objective To study the clinical features of children with colorectal polyps and the efficacy of endoscopic treatment.Methods A retrospective analysis was performed on the medical data of 1 351 children with colorectal polyps who were admitted and received colonoscopy and treatment in the past 8 years,including clinical features and the pattern and outcomes of endoscopic treatment.Results Among the 1 351 children,893(66.10%) were boys and 981(72.61%) had an age of 2-<7 years,and hematochezia(1 307,96.74%) was the most common clinical manifestation.Of all the children,89.27%(1 206/1 351) had solitary polyps,and 95.77%(1 290/1 347) had juvenile polyps.The polyps were removed by electric cauterization with hot biopsy forceps(6 cases) or high-frequency electrotomy and electrocoagulation after snare ligation(1 345 cases).A total of 1 758 polyps were resected,among which1 593(90.61%) were pedunculated and 1 349(76.73%) had a diameter of <2 cm.Postoperative complications included bleeding in 51 children(3.77%),vomiting in 87 children(6.44%),abdominal pain in 14 children(1.04%),and fever in39 children(2.89%),while no perforation was observed.The children aged <3 years had the highest incidence rates of postoperative bleeding and fever(P<0.0125),and the children with a polyp diameter of ≥2 cm had significantly higher incidence rates of postoperative bleeding,vomiting,and fever(P<0.05).Conclusions Solitary polyps,pedunculated polyps,and juvenile polyps are common types of pediatric colorectal polyps.Electric cauterization with hot biopsy forceps or high-frequency electrotomy and electrocoagulation after snare ligation can effectively remove colorectal polyps in children,with good efficacy and few complications.Younger age and larger polyp diameter are associated with a higher risk of postoperative bleeding.

关 键 词：结直肠息肉 幼年性息肉 便血 儿童 

分 类 号：R726.5[医药卫生—儿科]