摘要
目的总结帽状息肉病的病例特点以加强对帽状息肉病的认识。方法纳入2010-2021年本中心经组织学证实的8例帽状息肉病例,进行一般描述性分析。并与目前国内发表的3篇关于帽状息肉个案报道进行对比分析。结果本研究中的8例患者,临床表现有间断便血(6例,75.0%)、黏液便(2例,25.0%)、腹痛(1例,12.5%)、腹泻(4例,50.0%)、里急后重感(2例,25.0%)、直肠占位2例;息肉数量1~10余枚不等;病灶直径为1.1~8.0 cm;病灶部位多位于直肠(6例,75.0%);内镜下形态分别为帽状(3例,37.5%)、隆起状(2例,25.0%)、半球状(2例,25%)和盘状(1例,12.5%)等。8例病例的病理组织结果均可见炎性肉芽组织,腺体拉长、扩张,部分病例可见黏液湖、黏液外溢等表现。治疗方式包括EMR、ESD、外科手术、美沙拉嗪栓剂治疗、四联抗H.pylori疗法(艾司奥美拉唑、呋喃唑酮片、阿莫西林、胶体果胶铋胶囊)等手段,其中有3例初次治疗3~6个月后复查仍有帽状息肉残留,给予追加内镜治疗(2/3)和抗H.pylori治疗(1/3)后,所有患者均取得了不错的疗效,最长随访90个月未再复发。结论本中心帽状息肉病以男性为主,发病年龄轻。该病多以便血为主要临床症状表现,病变发生的主要部位在直肠,1/4的患者合并H.pylori感染,合并H.pylori感染的患者需要及时除菌治疗。除了根除H.pylori治疗外,内镜下切除病变、外科手术治疗均能取得较好疗效。
Objective To summarize the characteristics of cap polyposis patients to enhance the understanding of cap polyposis among clinical practitioners.Methods Eight cases of histologically confirmed cap polyps from our center from 2010 to 2021 were included for general descriptive analysis.It was also compared and analysed with 3 individual case reports on cap polyps published in China so far.Results Among the 8 patients in our center,the clinical manifestations included intermittent blood in the stool(6 cases,75.0%),mucus stool(2 cases,25.0%),abdominal pain(1 case,12.5%),diarrhea(4 cases,50.0%),a feeling of urgency(2 cases,25.0%)and rectal mass(2 cases,25.0%).The number of polyps ranged from 1 to more than 10;the diameter of the lesions ranged from 1.1 to 8.0 cm;the lesions were mostly located in rectum(6 cases,75.0%);the endoscopic patterns were cap-shaped(3 cases,37.5%),bulging(2 cases,25.0%),hemispherical(2 cases,25.0%)and disc-shaped(1 case,12.5%),etc.Pathological findings in all 8 cases showed inflammatory granulation tissue,elongated and dilated glands,and in some cases,mucus lakes and mucus spillage.The treatment modalities included EMR,ESD,surgery,Mesalazine suppository therapy,quadruple anti-H.pylori therapy.In 3 cases,the cap polyps remained after 3-6 months of initial treatment.After additional endoscopic treatment(2/3)and anti-H.pylori treatment(1/3).All patients had good results and no recurrence at a maximum follow-up of 90 months.Conclusion Cap polyposis in our center is predominantly male with a young age of onset.The main clinical symptom is haemorrhage and the lesion is mainly in the rectum.Some(1/4)patients have H.pylori infection and those with H.pylori infection require prompt debridement.In addition to H.pylori eradication treatment,endoscopic excision of the lesion and surgical treatment can be effective.
作者
范鑫
亢梓霖
陈文
金鹏
杨浪
贾燕
FAN Xin;KANG Zilin;CHEN Wen;JIN Peng;YANG Lang;JIA Yan(Department of Gastroenterology,the Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700;Department of Outpatient,Air Force Chifeng Station Hospital Clinic Chifeng City,China)
出处
《胃肠病学和肝病学杂志》
CAS
2024年第4期381-384,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
帽状息肉
幽门螺杆菌
炎性息肉
结肠息肉
Cap polyposis
Helicobacter pylori
Inflammatory polyps
Colonic polyps
