摘要
目的回顾性分析21例老年直肠神经内分泌肿瘤(RNEN)病人的临床表现及术后康复质量。方法收集从2014年11月至2019年12月期间我院经病理确诊的住院老年直肠神经内分泌肿瘤病人21例的临床资料,分析其内镜下治疗的临床特点,评价术后康复质量。结果RNEN主要临床表现为腹痛、腹泻、便血、肛门坠胀感等;肠镜下多表现为黏膜或黏膜下隆起;超声肠镜显示为以中低回声为主的起源于黏膜或黏膜下层的圆形结节;CT或MRI可见黏膜强化、管壁增厚、肿块、管腔狭窄;病人均行内镜下黏膜切除术(EMR)或剥离术(ESD);术后3 d康复评定示老年病人存在疼痛、抑郁、疲乏等生存质量问题,随访1年均无复发转移。结论老年RNEN发病隐匿,临床表现无明显特异性,故应加深对老年人发病的认识,做到早发现、早诊断及早治疗,同时老年病人早期术后康复需引起关注。
Objective To retrospectively analyze the clinical features and postoperative rehabilitation quality of 21 elderly patients with rectal neuroendocrine neoplasms(RNEN).Methods The clinical data of 21 elderly inpatients diagnosed as RNEN in our hospital from November 2014 to December 2019 were selected and analyzed.Results The major clinical manifestations were abdominal pain,diarrhea,hematochezia and anal pendant expansion.The appearance under colonoscopy were mostly mucosal or submucosal protuberance.Ultrasonic colonoscopy revealed a rounded nodule originating from the mucosa or submucosa with a moderate or hypoechoic dominant ultrasound.CT or MRI showed mucosal enhancements,wall thickenings,lumps,and lumen stenosis in patients.All patients underwent endoscopic mucosal resection(EMR)or dissection(ESD).The patients presented with pain,depression,fatigue and other problems in quality of life by using rehabilitation assessments 3 d after operation.No recurrence or metastasis occurred during the 1-year follow-up.Conclusions RNEN is delitescenced and often has no specific clinical manifestations,so the elderly patients should be examined comprehensively with early detections,diagnoses and treatments,meanwhile more attention should be paid to postoperative rehabilitation quality.
作者
张阳阳
汤琪云
张一清
ZHANG Yang-yang;TANG Qi-yun;ZHANG Yi-qing(Department of General Medicine;Department of Rehabilitation Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《实用老年医学》
CAS
2020年第10期1027-1029,1033,共4页
Practical Geriatrics
基金
江苏省卫计委第五期“333”工程项目(BRA2017535)。
关键词
老年人
直肠神经内分泌肿瘤
临床特点
康复质量
aged
rectal neuroendocrine neoplasms
clinical features
rehabilitation quality
