摘要
目的 分析结直肠息肉癌变患者的临床病理特征及内镜下手术治疗的疗效。方法 选择结直肠息肉癌变患者106例为观察对象,通过自制量表详细采集患者的临床病理资料。并根据治疗术式不同分成内镜组、对照组,各53例,对比两组患者围术期指标与术后并发症发生率、复发率。结果 106例结直肠息肉癌变患者,病灶位于近端结肠19例(17.92%)、远端结肠84例(79.25%),3例未确定(2.83%);临床表现为便血53例(50.00%);重度不典型增生45例(42.45%)、黏膜内癌61例(57.55%);大便潜血阳性65例(61.32%);息肉带蒂63例(59.43%)、广基43例(40.57%);息肉直径<2 cm者23例(21.70%)、≥2 cm者83例(78.30%);内镜组手术时间、复发率与对照组比较,无统计学差异(P>0.05);内镜组患者术后禁食时间、术后肠蠕动恢复时间、术后住院时间短于对照组,术中出血量、术后并发症发生率低于对照组,有统计学差异(P<0.05)。结论 年龄≥40岁、体重过重、有吸烟史、大便潜血阳性等患者出现结直肠息肉癌变的风险高,临床需定期开展电子结肠镜筛查,且针对患者采取内镜手术治疗能减少术中出血量,缩短术后恢复时间和住院时间,减少复发,值得推广。
Objective To study the clinicopathological characteristics of cancerous colorectal polyps patients,and to analyze the therapeutic effect of endoscopic surgery,in order to provide a reference for the standardized clinical treatment of colorectal cancer.Methods 106 cancerous patients with colorectal polyps were selected.Clinical data were collected by self-made scale to analyze clinicopathological characteristics.According to the different treatment types,they were divided into endoscopic groups and the control group,with 53 cases each.Compared the perioperative index with the postoperative complication rate and recurrence rate.Results Among the 106 patients with cancerous colorectal polyps,the lesion was located in the proximal colon in 19 cases(17.92%),and 84 cases in the distal colon(79.25%),3 cases uncertain(2.83%);The clinical manifestations was hematochezia in 53 cases(50.00%);Severe dysplasia in 45 cases(42.45%),and internal mucosal carcinoma in 61 cases(57.55%);Stcult blood positive 65 cases(61.32%);63 cases pedunculated polyp(59.43%)and 43 cases sessile polyp(40.57%);23 polyps(21.70%)<2 cm,and 83 polyps≥2 cm(78.30%);Operation time and recurrence rate in the endoscopic group and the control group had no statistical difference(P>0.05);Postoperative fasting time,postoperative bowel peristalsis recovery time,postoperative hospital stay time in the endoscopic group was shorter than that in the control group,The intraoperative bleeding volume and the postoperative complication rate were lower than the control group,there had statistical difference(P<0.05).Conclusion Age≥40,overweight,smoking history,stool latent blood positive patients with colorectal polyp cancer risk,clinical need to regularly conduct electronic screening colonoscopy,and for patients with endoscopic surgery can reduce intraoperative bleeding,shorten the postoperative recovery time and hospital stay,reduce recurrence,is worth promoting.
作者
程艳敏
关胜男
CHENG Yanmin;GUAN Shengnan(Henan Provincial Cancer Hospital,Zhengzhou,450008)
出处
《实用癌症杂志》
2024年第3期498-501,共4页
The Practical Journal of Cancer
关键词
结直肠息肉癌变
临床病理特征
开腹手术
内镜手术
围术期指标
Cancerous colorectal polyps
Clinicopathological features
Open surgery
Endoscopic surgery
Perioperative indicators
