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本文总结了我院自1980~1998年3月的2400例老年纤维结肠镜的检查。并统计了老年人24种大肠疾病和其检出率,而后对大肠瘤和大肠息肉,进行分析和叙述。在2400例老年人中。共检出息肉776例,检出率为32.33%,单发者371例(47.81%),多发者405例(52.19%),共检出息肉1851颗。大肠息肉中,以腺瘤性息肉居多,共482例(62.10%)。在活检或手术标本的切片中,腺瘤组织与癌灶并存者46例,其癌变率为8.24%,而混合性息肉和绒毛状息肉的癌变率则分别为12.34%和45.31%。在活检标本中,腺瘤性息肉的异型增生,轻度者43%,中度者24%,重度者13%。本组共检出大肠癌392例,检出率为16.33%。左侧结肠和右侧结肠,在症状上有所差异。老年人感觉迟钝,症状常不明显,因此对大便习惯改变者,腹痛便血者,及粘液便者应进行肛诊及大便潜血的检查。直肠癌肛诊的阳性率约75%,大肠癌大便潜血的阳性率为72%。大肠癌,直肠与乙状结肠为好发部位,左侧结肠占发病率的70%。病灶超过1/2周肠壁者,共319例(81.37%),其病程均在一年以上,大都为进展期,经手术等证实属早期者,仅14%,所以我们应放宽肠镜检查尺度,使患者消除恐惧,一些可疑的患者,都能及时的检查。以腺癌最为常见,占75.76%,粘液痛与印戒细胞癌分别占18.36%和3.82%,此外我们还检出1例较为少见的腺鳞癌。本
This article summarizes the examination of 2,400 elderly colonoscopy patients in our hospital from March 1980 to March 1998. The statistics of 24 kinds of large intestine diseases in the elderly and their detection rate, and then analyze and describe the colorectal tumors and colorectal polyps. In 2400 elderly people. A total of 776 polyps were detected. The detection rate was 32.33%, 371 cases (47.81%) were single-onset, and 405 cases (52.19%) were multiple-onset. A total of 1851 polyps were detected. In colorectal polyps, there were mostly adenoma polyps, a total of 482 cases (62.10%). In the section of biopsy or surgical specimens, there were 46 cases of adenomatous tissue and cancerous lesions, the cancerous rate was 8.24%, while the mixed cancerous rates of mixed polyps and villous polyps were 12.34% and 45.31%, respectively. In the biopsy specimens, dysplasia of adenomatous polyps was observed in 43% of mild cases, moderate cases of 24%, and severe cases of 13%. A total of 392 cases of colorectal cancer were detected in this group, and the detection rate was 16.33%. The left colon and right colon differ in their symptoms. Older people feel dull and their symptoms are often not obvious. Therefore, changes in stool habits, abdominal pain and blood in the stool, and mucous stools should be checked for fecal occult blood. The positive rate of rectal cancer rectal examination is about 75%, and the positive rate of colorectal cancer fecal occult blood is 72%. Colorectal cancer, rectal and sigmoid colons are the predilection sites, and the left colon accounts for 70% of the incidence. There were 319 cases (81.37%) whose lesions were more than one-half week old, and the course of disease was more than one year. Most of them were in advanced stage. It was early stage confirmed by surgery, only 14%, so we should relax the colonoscopy. Scales enable patients to eliminate fears, and some suspicious patients can be promptly examined. Adenocarcinoma was the most common, accounting for 75.76%. Myxoma and signet-ring cell carcinoma accounted for 18.36% and 3.82%, respectively. In addition, we also detected a rare case of adenosquamous carcinoma. this