摘要
结肠镜检查发现的结直肠息肉以直径≤5mm的微小息肉（DP）最为常见。目前关于DP内镜下处理方式的报道尚少。目的：分析结直肠DP的内镜、病理特点和处理方式，为其临床诊治提供参考。方法：收集2010年1月～2011年4月青岛市市立医院结肠镜检查病例的临床资料．纳人其中发现结直肠息肉并符合DP标准者．凡合并较大息肉（≥6mm）者予以排除。回顾性分析DP的内镜特点、病理性质和处理方式。结果：共纳入结直肠DP病例269例（402枚DP），占同期息肉检出例数的21．8％，其中180例（66．9％）为单发。43．3％的DP分布于直肠、乙状结肠，60．0％的DP直径〉3mm，绝大多数DP形态为山田I型（53．5％）或山田Ⅱ型（42．0％）。305枚送病理检查的DP中．绝大多数为腺瘤性息肉（50．2％）或炎性息肉（47．5％）：〉3mm的DP为腺瘤性的可能性较大，≤3mm者多为非肿瘤性（P〈0．05）。66．9％的DP系以活检钳钳除：〉3mm、山田Ⅱ＋Ⅲ型和多发DP采用热活检钳钳除或高频电凝切除的可能性较≤3mm、山田I型和单发DP更大（P〈0．05）。结论：对于直径〉3mm的结直肠DP，行内镜下高频电凝切除可能更为有效，并应送病理检查，以免漏诊进展期腺瘤。
Diminutive polyp （DP, 〈5 mm in diameter） is the most common type of colorectal polyps detected by colonoscopy, however, studies focusing on endoscopic management of DP are relatively rare. Aims： To analyze the endoscopic and pathological characteristics and management of colorectal DP, thus to provide a reference for it diagnosis and treatment. Methods： Clinical data of patients referred for colonoscopy and diagnosed as having coJorectal DP between Jan. 2010 and Apr. 2011 at Qingdao Municipal Hospital were collected. Those with synchronous polyps ~〉6 mm in diameter were excluded. Endoscopic and pathological characteristics and management of DP were analyzed retrospectively. Results： A total of 269 patients with 402 colorectal DPs were enrolled, which accounted for 21.8% of the polyps cases. Of the 269 patients, 180 （66.9%） had only a single DP. 43.3% of the DPs were located in the rectum and sigmoid colon, and 60.0% of the DPs were 〉3 mm in diameter. Most DPs appeared as Yamada type I （53.5%） or Yamata type Ⅱ（42.0%）. Of the 305 DPs received pathological evaluation, most were adenomatous polyps （50.2%） or inflammatory polyps （47.5%）. DIPs 〉3 mm were more likely to be neoplastic, while those ≤3 mm were more likely to be nonneoplastic （P〈0.05）. 66.9% of the DPs were removed by cold biopsy. As compared with DPs ≤ 3 mm, Yamata type I DPs and solitary DP, it was more likely that DPs 〉3 ram, Yamada type ]1 ＋BI DPs and multiple DPs were removed by hot biopsy or high frequency electrotomy （P〈0.05）. Conclusions： Endoscopic high frequency eleetrotomy may be more effective for colorectal DP 〉3 mm in diameter, and pathological evaluation is necessary for avoiding the missing diagnosis of advanced adenoma.
出处
《胃肠病学》
2012年第1期30-32,共3页
Chinese Journal of Gastroenterology
关键词
微小息肉
大肠
结肠镜检查
息肉切除术
病理学
Diminutive Polyps
Intestine, Large
Colonoscopy
Polypeetomy
Pathology
