大肠癌术后结肠镜随访临床分析.docVIP

大肠癌术后结肠镜随访临床分析 　　【摘要】 目的 探讨结肠镜随访对大肠癌术后复发的临床意义。方法 自2000年1月至2008年12月,对138例大肠癌术后患者进行结肠镜随访检查,发现可疑病变取活检,发现息肉则行镜下凝固治疗,秩和检验进行随访结果统计分析。结果 138例患者检出复发癌12例,其中男性10例,女性2例,两者差异显著(P0.05);其中吻合口复发癌8例,原发癌4例,治疗息肉22例,共36枚,其中腺瘤性息肉26例、吻合口炎10例。12例复发癌患者中,正规随访者11例,未正规随访者仅1例,两者差异显著(P0.001);术后2年内复发11例,1例发生于3.5年,差异显著(P0.001)。结论 大肠癌术后2年内常规进行结肠镜检查可早期发现复发病灶,并可切除腺瘤性息肉,对降低大肠癌复发具有较大的临床价值。 　　【关键词】 大肠癌;结肠镜;随访;复发 　　 　　Clinical analysis of postoperative colonoscopy on patients subjected to follow-up of Colorectal Cancer 　　 　　【Abstract】 Objective To discuss the clinical value of colonoscopy follow-up on the postoperative re- 　　? 　　作者单位:625011 　　湖南省岳阳市三人民医院 　　(岳阳市血吸虫病专科医院) 　　 　　currence of colon cancer.Methods From 2000.Jan to 2008.Dec, 138 cases of colorectal cancer were postoperatively followed-up by colonoscopy, with suspicious lesions biopsy, polyps being coagulated, rank sum test for statistical analysis.Results 12 of 138 cases were relapsed in colorectal cancer, with 10 cases of men, and 2 cases of women, in significant difference (P 0.05); 8 cases were anastomotic cancer, other 4 cases in situ; 36 polyps in all of 22 patients were treated, with 26 adenomatous polyps, 10 cases of anastomotic inflammation. 11 of 12 relapsed cases were regularly followed-up, while only 1 case in group without regular following-up , in significant differences (P0.001); 11 cases recurred within 2 years after surgery, while 1 case in 3.5 years postoperatively, that was significantly different (P0.001).Conclusion Conventional colonoscopy within 2 years postoperatively is important for the early detection of recurrent lesions, and removal of adenomatous polyps to reduce the recurrence of colorectal cancer have greater clinical value. 　　【Key words】Colorectal cancer;Colonoscopy; follow-up;Recurrence 　　 　　大肠癌是常见的消化道恶性肿瘤之一,手术成功率高,但术后复发和转移仍是导致患者死亡的主要原因。因此对大肠癌术后患者进行及时有效的随访检查对于减低复发率具有重要的临床意义,目前结肠镜检查已成为临床常用的随访手段。自2000年1月至2008年12月,本院对138例大肠癌患者术后进行结肠镜随访检查,分析如下。 　　1 资料与方法 　　1.1 一般资料 138例患者中,男84例,女54例,平均年龄(47.3±16.56