摘要
目的:评估内镜下切除结直肠腺瘤性息肉的疗效及其预后。方法:2017年3月至2019年3月宁波大学医学院附属阳明医院消化内科共168例结直肠腺瘤性息肉患者行内镜下电凝切除术。将患者分为青年组(≤34岁)、中年组(35~59岁)和老年组(≥60岁),对腺瘤部位及病理类型进行分析,观察术后并发症及复发情况,采用SF-36量表评估患者生活质量。结果:腺瘤性息肉发生部位左半结肠明显多于右半结肠,以直肠(61例,占36.3%)最常见。青年组病理分型均为管状腺瘤,中年组以管状腺瘤为主(84例,占83.2%),老年组绒毛状腺瘤比例大幅上升(11例,占26.8%),部分腺瘤出现局部癌变(2例,占4.9%),随着年龄的增大,混合性腺瘤及绒毛状腺瘤的百分比逐渐增大,各组间比较差异有统计学意义(P<0.05)。术后并发症主要为出血(17例,占10.1%)、穿孔(2例,占1.2%),均来自老年组,主要原因是息肉过大及切除过深;所有患者均未发生感染。随访12个月复发8例(老年组6例,中年组2例),复发率为4.8%。患者术后总体生活质量得分高于术前,各维度得分(精神健康、生理功能、社会功能、总体健康及躯体疼痛)高于术前,差异均有统计学意义(P<0.05)。结论:内镜下切除结直肠腺瘤性息肉效果确切,术后并发症发生率及复发率均较低,患者总体生活质量得到改善。
Objective:To explore the clinical effect and prognosis of endoscopic colorectal adenomatous polypectomy.Methods:From March 2017 to March 2019,168 inpatients with colorectal adenomaunderwent endoscopic electrocoagulation resection in the Department of Gastroenterology of Yangming Hospital affiliated to the Medical School of Ningbo University.They were divided as young group(≤34 years old),middle-aged group(35-59 years old)and elderly group(≥60 years old).The site and pathological type of adenoma were analyzed and the postoperative complications recurrence observed.SF-36 scale was used to evaluate the quality of life of the patients.Results:Adenomatous polyps were more common in the left half of the colon than in the right one,with rectum being the most common(61 cases,accounting for 36.3%).Tubular adenoma was the only pathological type found in the young group,and it was the predominant type in the middle-aged group(84 cases,accounting for 83.2%).The proportion of villous adenoma increased significantly in the elderly group(11 cases,accounting for 26.8%).Some adenomas showed local cancerization(2 cases,accounting for 4.9%).With the increase of age,the percentage of mixed adenomas and villous adenomas gradually increased,and the difference between groups was statistically significant(P<0.05).Postoperative complications were mainly hemorrhage(17 cases,accounting for 10.1%)and perforation(2 cases,accounting for 1.2%),all of which were found in the elderly group.None of the patients developed infection.There were 8 cases of recurrence(6 cases in the elderly and 2 in the middle-aged group),and the recurrence rate was 4.8%.The overall quality of life score after operation was higher than that before surgery,and scores of all dimensions(mental health,overall health and physical pain)were higher than those before surgery,with statistical difference(P<0.05).Conclusion:Endoscopic resection of colorectal adenomatous polyps was effective in that the incidence of postoperative complications and recurrence rate were low but the patients’overall quality of life was improved.
作者
蔡升
褚建锋
周建波
桑建忠
杨倩倩
方莹
齐李对
鲁姗姗
CAI Sheng;CHU Jianfeng;ZHOU Jianbo;SANG Jianzhong;YANG Qianqian;FANG Ying;QI Lidui;LU Shanshan(Department of Gastroeuterology,the Affiliated Yangming Hospital of Ningbo University,Yuyao People’s Hospital,Ningbo 315400,China)
出处
《温州医科大学学报》
CAS
2021年第3期237-239,243,共4页
Journal of Wenzhou Medical University
基金
余姚市科技计划项目(2019YPT07)。
关键词
内镜治疗术
结直肠息肉
腺瘤性息肉
疗效
预后
生活质量
therapeutic endoscopy
colorectal polyp
adenomatous polyp
efficacy
prognosis
quality of life
