2669例儿童肠息肉的临床特征及继发肠套叠的危险因素分析  

Clinical features of intestinal polyps and risk factors for secondary intussusception in children:an analysis of 2669 cases

作　　者：李灿琳 罗艳红[1] 欧阳红娟[1] 刘莉[1] 张文婷[1] 姜娜 段佳琪 湛美正 刘晨曦 游洁玉[1] 李勇[2] 赵红梅[1] LI Can-Lin;LUO Yan-Hong;OUYANG Hong-Juan;LIU Li;ZHANG Wen-Ting;JIANG Na;DUAN Jia-Qi;ZHAN Mei Zheng;LIU Cheng-Xi;YOU Jie-Yu;LI Yong;ZHAO Hong-Mei(Department of Digestive Nutrition,Hunan Children's Hospital,Changsha 410000,China)

机构地区：[1]湖南省儿童医院消化营养科,湖南长沙410000 [2]湖南省儿童医院普外科,湖南长沙410000

出　　处：《中国当代儿科杂志》2022年第5期530-535,共6页Chinese Journal of Contemporary Pediatrics

基　　金：湖南省自然科学基金面上项目(2019JJ40155)。

摘　　要：目的探讨儿童肠息肉的临床特征及继发肠套叠的危险因素。方法回顾性收集2669例肠息肉患儿的临床资料,根据是否继发肠套叠,分为肠套叠组(n=346)和非肠套叠组(n=2323)。比较分析两组患儿的临床资料,采用多因素logistic回归分析儿童肠息肉继发肠套叠的危险因素。结果62.42%肠息肉患儿为学龄前儿童,男女比例2.08∶1,92.66%以便血起病,94.34%为左半结肠及直肠息肉。继发肠套叠346例,发生率为12.96%(346/2669)。息肉越大、多发息肉(≥2个)、分叶形息肉是继发肠套叠的危险因素(分别OR=1.644、6.034、93.801,P<0.001)。结论儿童肠息肉好发于学龄前,男性多见,多数以便血起病,好发部位为左半结肠及直肠;息肉越大、多发息肉、息肉形态为分叶形,继发肠套叠的风险越高,需尽早内镜干预,以改善预后。Objective To study the clinical features of intestinal polyps and the risk factors for secondary intussusception in children.Methods A retrospective analysis was performed for the medical data of 2669 children with intestinal polyps.According to the presence or absence of secondary intussusception,they were divided into two groups:intussusception(n=346)and non-intussusception(n=2323).Related medical data were compared between the two groups.The multivariate logistic regression analysis was used to identify the risk factors for secondary intussusception.Results Among the children with intestinal polyps,62.42%were preschool children,and the male/female ratio was 2.08∶1;92.66%had hematochezia as disease onset,and 94.34%had left colonic polyps and rectal polyps.There were 346 cases of secondary intussusception,with an incidence rate of 12.96%(346/2669).Large polyps(OR=1.644,P<0.001),multiple polyps(≥2)(OR=6.034,P<0.001),and lobulated polyps(OR=93.801,P<0.001)were the risk factors for secondary intussusception.Conclusions Intestinal polyps in children often occur in preschool age,mostly in boys,and most of the children have hematochezia as disease onset,with the predilection sites of the left colon and the rectum.Larger polyps,multiple polyps,and lobulated polyps may increase the risk of secondary intussusception,and endoscopic intervention is needed as early as possible to improve prognosis.

关 键 词：肠息肉 肠套叠 内镜 儿童 

分 类 号：R725.7[医药卫生—儿科]