进展期结直肠腺瘤患者危险因素及内镜治疗后随访情况回顾性研究  

Retrospective study on risk factor and follow-up of patients with advanced colorectal adenoma after endoscopic therapy

作　　者：谭英斌 周郁芬[2] 谢玲[2] 吴云林[2] 陈平[2] TAN Ying-bin;ZHOU Yu-fen;XIE Ling;WU Yun-lin;CHEN Ping(Department of Spleen and Gastric Diseases,Kunshan Hospital of Integrated Traditional Chinese and Western Medicine,215332 Kunshan,Jiangsu,China;Department of Gastroenterology,Northern Branch of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,201801 Shanghai China)

机构地区：[1]昆山市中西医结合医院脾胃病科,江苏昆山215332 [2]上海交通大学医学院附属瑞金医院北部院区消化内科,上海201801

出　　处：《临床消化病杂志》2023年第1期25-29,共5页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨内镜下治疗后进展期结直肠腺瘤一般情况和高危因素。[方法]收集100例进展期腺瘤(进展期腺瘤组)患者及200例非进展腺瘤(非进展期腺瘤组)患者基本信息,分析患者血糖、胆固醇、三酰甘油、尿酸和癌胚抗原(CEA)水平,以及高危因素如伴发慢性阑尾炎、胆囊炎/胆囊结石、炎症性肠病、糖尿病、有其他肿瘤病史或有一级亲属结直肠癌病史等,其后记录进展期腺瘤患者初次内镜下复查结果及高危因素,解析与疾病相关的因素。[结果]进展期腺瘤组与非进展期腺瘤患者组间体质量比较差异无统计学意义,而年龄、血糖、三酰甘油、尿酸和CEA水平比较差异有统计学意义(P<0.05),2组患者在炎症性肠病,糖尿病和一级亲属有结直肠肿瘤史高危因素中比较差异有统计学意义(P<0.05)。初次随访内镜显示:进展期腺瘤组中绒毛状腺瘤患者复查结直肠息肉阳性率较高,与其他进展期腺瘤者比较差异有统计学意义(P<0.05),但在息肉的部位和病理性质间无显著差异(P>0.05),另发现有吸烟史、饮酒史与糖尿病史患者复查结直肠息肉阳性率更高(P<0.05)。[结论]对于进展期腺瘤患者伴高危因素的人群应及时行内镜复查,进而有效的预防和降低结直肠癌的发病率。[Objective]To investigate the general situation and high risk factors of advanced colorectal adenoma after endoscopic treatment, and follow-up the results of the first endoscopic review to analyze the regularity of its incidence, so as to guide the clinical and scientific research work in the future.[Methods]Basic information of 100 cases of patients with advanced adenomas and 200 cases of no-advanced adenoma patients were collected, the patients’ blood sugar, cholesterol, triglycerides, uric acid and CEA levels, and these risk factors including chronic appendicitis, cholecystitis/gallstones, inflammatory bowel disease, diabetes, or have other tumors or a first-degree family history of colorectal cancer were analyzed.The initial endoscopic results and risk factors of patients with advanced adenoma were followed up to analyze.[Results]The patients with advanced adenomas between these patients with no-advanced adenomas, which showed no statistically significant difference for weight, but age, serum glucose, triglycerides, uric acid and blood CEA levels of blood compare difference were statistically significant in patients with advanced adenomas compared with the patients with no-advanced adenomas in inflammatory bowel disease, diabetes history of other tumors and a history of colorectal cancer in a first-degree relative(P<0.05).For the first time of follow-up with patients after treatment by endoscopy showed that the difference of colorectal polyps positive rate was significant, but the location and pathological nature of polyps was no significant difference in villous adenoma group compared with other advanced adenomas group(P<0.05).The concurrent of colorectal polyps in patients with the history of smoking, drinking or diabetes were higher(P<0.05).[Conclusion]For patients with advanced adenoma with high risk factors, timely endoscopic review should be performed in order to achieve early detection of diseases, so as to effectively prevent and reduce the incidence of colorectal cancer.

关 键 词：结直肠腺瘤 息肉 危险因素 结肠镜 

分 类 号：R735.3[医药卫生—肿瘤]