便秘型与腹泻型结直肠息肉的临床特点及上皮内瘤变  

Case characteristics and intraepithelial neoplasia of constipation and diarrhea type colorectal polyps

作　　者：曲彤烁 张立平[1,2] 王林恒[2] 王磊[2] 姚玉璞[2] QU Tongshuo;ZHANG Liping;WANG Linheng;WANG Lei;YAO Yupu(Beijing University of Traditional Chinese Medicine,Beijing 100029,China;Department of Gastroehterology and Hepatology,Beijing University of Traditional Chinese Medicine Oriental Hospital,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院脾胃肝胆科,北京100078

出　　处：《西部医学》2023年第11期1620-1624,共5页Medical Journal of West China

基　　金：北京市自然科学基金资助项目(7212181);北京市科技计划课题·生命医药与生命科学创新培育研究项目(Z171100000417051);北京中医药大学重点攻关项目(2020-JYB-ZDGG-138)。

摘　　要：目的 探讨便秘型与腹泻型结直肠息肉之间的临床特点及上皮内瘤变,以期为临床诊疗提供理论依据。方法 选取2017年1月—2021年12月于北京中医药大学东方医院消化内镜中心行电子肠镜检查并发现结直肠息肉的852例患者的临床资料,利用统计软件分析便秘型(n=412)与腹泻型(n=440)患者的临床特点和上皮内瘤变的合并情况。结果 便秘型结直肠息肉患者以女性居多,腹泻型结直肠息肉患者以男性居多,且年龄多在50~69岁之间;便秘型患者易合并结肠黑变病和憩室,腹泻型患者易合并末端回肠炎和内痔;两类型患者息肉分布部位主要集中在左半结肠,以直肠、乙状结肠、横结肠为主;病变部位位于乙状结肠、直肠、升结肠且直径≥1.0 cm的管状腺瘤和绒毛管状腺瘤更易合并上皮内瘤变。结论 便秘型与腹泻型结直肠息肉患者在年龄、性别、合并疾病存在统计学差异,上皮内瘤变无统计学差异。对于50岁以上人群应及早进行正规肠镜检查,不放过任何一个可疑病灶,对于结直肠癌的预防和预后有重要意义。Objective To collect the data of patients with colorectal polyps with constipation and diarrhea as the main complaint,record the age,gender,combined diseases and intraepithelial neoplasia,and explore the difference and relationship between constipation type and diarrhea type colorectal polyps,so as to provide theoretical basis for clinical diagnosis and treatment.Methods Clinical data of 852 patients who underwent electronic colonoscopy and found colorectal polyps in the Digestive Endoscopy Center of Oriental Hospital of Beijing University of Chinese Medicine from January 2017 to December 2021 were selected.The constipation(n=412)and diarrhea(n=440)in patients with clinical characteristics and intraepithelial neoplasia mergers were analyzed.Results There were constipation in patients with colorectal polyps in the majority with women,diarrhea patients with colorectal polyps in the majority with men,and age between 50~69 years old.Patients with constipation were more likely to have colonic melanism and diverticula,while patients with diarrhea were more likely to have terminal ileus and internal hemorrhoids.Polyps in the two types of patients were mainly distributed in the left half colon,mainly in the rectum,sigmoid colon and transverse colon.Tubular adenomas and villous tubular adenomas located in sigmoid,rectum and ascending colon with a diameter≥1.0 cm were more likely to be complicated with intraepithelial neoplasia.Conclusion There are statistical differences in age,gender,and comorbidities between patients with constipation type and diarrhea type colorectal polyps,while there is no statistical difference in intraepithelial neoplasia.For people over 50 years old,regular colonoscopy should be conducted as soon as possible,without leaving any suspicious lesions behind,which is of great significance for the prevention and prognosis of colorectal cancer.

关 键 词：便秘 腹泻 结直肠息肉 病例特点 上皮内瘤变 

分 类 号：R574.6[医药卫生—消化系统]