临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (10): 738-.doi: 10.3969/j.issn.1000-3606.2018.10.003

• 营养消化系统专栏 • 上一篇    下一篇

儿童结直肠息肉 670 例临床分析

茆康卫 1, 练敏 2, 刘志峰 2, 潘键 2, 郑必霞 2, 姚玉前 1, 李大雷 1   

  1. 1.徐州医科大学附属连云港医院儿内科(江苏连云港 222002);2. 南京医科大学附属儿童医院消化科 (江苏南京 210008)
  • 收稿日期:2018-10-15 出版日期:2018-10-15 发布日期:2018-10-15
  • 通讯作者: 练敏  E-mail:13337836374@163.com
  • 基金资助:
    国家专科建设项目小儿消化专业资助项目(No.201298)

Clinical analysis of colorectal polyps in 670 children

MAO Kangwei1, LIAN Min2, LIU Zhifeng2, PAN Jian2, ZHENG Bixia2, YAO Yuqian1, LI Dalei1   

  1. 1.Department of Pediatrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang 222002, Jiangsu, China; 2.Department of Gastroenterology, Nanjing Children’s Hospital Affiliated to Nanjing Medical University, Nanjing 210008, Jiangsu, China
  • Received:2018-10-15 Online:2018-10-15 Published:2018-10-15

摘要:  目的 探讨儿童结直肠息肉的临床特点以及内镜下黏膜剥离切除术(EMR)的治疗价值。方法 回顾分析 2012年至2017年收治的确诊为结直肠息肉后立即行EMR的患儿临床资料。结果 670例患儿中,男423例、女237例,平 均确诊年龄(4.50±2.69)岁,高发于3~6岁(43.4%)。 临床表现以便血(90.3%)为主。息肉以单发(92.5%)为主,多发 于直肠(49.0%)及乙状结肠(35.2%);直径多<2 cm(78.9%)。 息肉≥2 cm者需钛夹夹闭创面,而息肉直径<2 cm者钛 夹对术后出血无影响。术后并发出血主要发生在术后第1天。术后病理回报提示以幼年性息肉为主。结论 结直肠息肉高 发于学龄前男童,以幼年性息肉为主;EMR辅以金属钛夹可减少术后出血。

Abstract: Objective To explore the clinical features of colorectal polyps in children and the therapeutic value of endoscopic mucosal resection (EMR). Method The clinical data of 670 children with colorectal polyps who underwent EMR immediately after the diagnosis from 2012 to 2017 were retrospectively analyzed. Results Among 670 children (423 males, 232 females), the average diagnosis age was 4.50±2.69 years old, with high incidence at the age of 3 to 6 years (43.4%). The clinical presentation was dominated by hemafecia (90.3%). Most of the polyps were solitary (92.5%), mostly in the rectum (49.0%) and sigmoid colon (35.2%) with diameter <2 cm (78.9%). For polyps with diameter ≥2 cm, titanium clips should be used to close the wounds, while for those with diameter <2 cm, titanium clips have no effect on postoperative bleeding. Postoperative bleeding mainly occurred on the first day after operation. Postoperative pathological findings suggested that juvenile polyp was predominant. Conclusions Colorectal polyps are most common in preschool boys and most of them are juvenile polyps. EMR supplemented with metal titanium clips can reduce postoperative bleeding.