临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (11): 860-.doi: 10.3969/j.issn.1000-3606.2017.11.015

• 综合报道 • 上一篇    下一篇

儿童结肠息肉临床诊治分析

王洋 1,2  , 金忠芹 1 , 武庆斌 1   

  1. 1.苏州大学附属儿童医院(江苏苏州 215000);2.江苏省泰兴市人民医院(江苏泰兴 225400)
  • 收稿日期:2017-11-15 出版日期:2017-11-15 发布日期:2017-11-15
  • 通讯作者: 金忠芹 E-mail:sunyu0628@126.com

Analysis of diagnosis and treatment of childhood colonic polyps

 WANG Yang 1,2 , JIN Zhongqin1, WU Qingbin1   

  1. 1.Children’s Hospital of Soochow University, Suzhou 215000,Jiangsu, China; 2.Taixing People’s Hospital of Jiangsu Province,  Taixing 225400,Jiangsu, China
  • Received:2017-11-15 Online:2017-11-15 Published:2017-11-15

摘要: 目的 分析儿童结肠息肉的临床特点、影响因素、镜下息肉形态及组织病理特点。方法 回顾分析经电子肠 镜检查确诊并行镜下息肉摘除术的193例结肠息肉住院患儿的临床资料。结果 193例患儿中,男131例,女62例,平均 年龄(4.61±2.16)岁。病程最短平均(7.29±8.30)个月(1周~4年)。 结肠息肉以便血(98.97%)、腹痛(17.10%)、肛 门肿物突出(13.47%)为主要临床表现。193例患儿共发现结肠息肉197枚;其中4例各有2枚息肉,其余均为单发息肉。 左侧结肠息肉188枚(95.43%),右侧结肠息肉仅9枚(4.57%)。 巨大息肉(>1.5cm)61枚 (30.96%),大息肉(0.6~1.5 cm)119枚(60.40%),小息肉(≤0.5cm)17枚(8.63%),按息肉大小分组,三组患儿的年龄、性别及病程长短差异无统计 学意义(P>0.05)。 息肉病理类型以错构瘤性息肉为主,占98.69%,炎性息肉仅占1.31%,未见腺瘤性息肉及恶变性息肉。 结论 便血、腹痛和肛门肿物突出是儿童结肠息肉的最主要的临床表现;结肠息肉对患儿营养状况及生长发育影响不大; 便秘及过敏性疾病可能是结肠息肉发展的影响因素;结肠息肉的大小与患儿年龄、性别及病程长短等因素无密切关联。

Abstract: Objective To analyze the influence factors of pathogenesis, clinical manifestations, microscopic morphology and histopathology in children with colonic polyps. Methods 193 cases of colonic polyps were collected in the children’s hospital of Soochow University during the period of July 2010 to July 2015. According to the length of the course, all cases were divided into two groups: short-term group (6 months or less), long-term group (> 6 months). Results There were 131 boys and 62 girls. The average age was 4.61±2.16 years old. The average disease duration was 7.29±8.30 months (one week to 4 years). There was no significant difference between the two groups in the rate of underweight and anemia, the level of hemoglobin, serum albumin and pre-albumin (P >0.05); The main clinical manifestation included hematochezia (98.7%), abdominal pain (17.10%) and protruding tumor (13.47%); The colonoscopy found 197 polyps, in which 189 were single polyp (95.94%), and 8 were multiple polyps (4.06%). Nine polyps (4.57%) were in the right colon, and 188 polyps (95.43%) in the left colon. All of the polyps were divided into 3 groups: huge polyps group (> 1.5 cm), large polyps group (0.5~1.5 cm), and small polyps group (<0.5 cm). There were 17 cases found with small polyps (8.63%), 119 cases with large polyps (60.40%), and 61 cases with huge polyps (30.96%). Between the three groups, there was no significant difference in age, gender, and duration of the disease (P>0.05). Histopathologic examination showed that most polyps were juvenile polyps (98.69%), inflammatory polyp account for 1.31%. No adenomatous polyps and malignant polyps were found. Conclusions Hematochezia, abdominal pain and anal tumor are the main complains of colonic polyps in children, there was no significant difference in age and gender. The colonic polyps only have few effects on nutritional status, growth and development in children. Constipation and atopic constitution may be important factors in the development of colonic polyps. The size of colonic polyps has no close relationship with the age, gender and duration of the disease.