潮汕地区大肠癌危险因素的病例-对照研究-普通外科学专业论文.docx

中 文 摘 要 目的 研究广东省潮汕地区大肠癌的相关危险因素，为本地区大肠癌的防治工作提供科学依 据；并在此基础上研究有统计学意义的生活方式及饮食习惯的改变是否与近年来大肠癌发 病部位向右移的特点相关，为近几年大肠癌发病特点的改变与生活方式及饮食习惯改变相 关提供理论依据。 方法 采用基于结肠镜检查及活检结果的病例对照研究，应用 Logistic 回归分析对可能的危 险因素先行单因素分析，发现某些有意义的因素后，纳入用 Logistic 回归模型进行非条件 多因素分析。经多因素分析得出有统计学意义的因素后，再用 X2 检验分析这些因素与大 肠癌发病部位向右移是否相关。 结果 有统计学意义的危险因素有年龄(OR 1.861,95%CI 1.795-1.932)、体重指数增加(OR 5.056,95%CI 1.714-14.915)、以肥肉摄入为主(OR 5.856,95%CI 3.484-8.276)、经常吃 腌菜和腊肉(OR 2.806,95%CI 1.488-5.291)、运动量少（偶尔运动）(OR 2.276,95%CI 1.385-4.587) 、 大 便 次 数 增 多 (OR 5.579,95%CI 1.513-20.568) 、 排 粘 液 血 便 (OR 4.531,95%CI 1.065-19.284)、有胆囊疾病或切除病史(OR 3.595,95%CI 2.231-5.793) 及家族肠癌史(OR 4.090,95%CI 1.841-9.082)。大肠癌发病部位向右移的相关因素有年 龄(X2 12.151,P 0.0163)、运动量少（偶尔运动）(X2 9.663, P 0.0465)及有胆囊疾病或 切除病史(X2 15.362,P 0.005)。 结论 潮汕地区结直肠癌的发病与年龄、体重指数增加、以肥肉摄入为主、经常吃腌菜和腊 肉、运动量少（偶尔运动）、大便次数增多、排粘液血便、有胆囊疾病或切除病史及家族 I 肠癌史有关；大肠癌发病部位向右移与年龄、运动量少（偶尔运动）及有胆囊疾病或切除 病史相关。 关键词：大肠癌；危险因素；病例对照研究； Abstract Objective To investigate the risk factors of colorectal cancer in Chaoshan area, Guangdong province, and to provide better scientific basis for prevention of colorectal cancer in this area; Based on this study, analysis on the relationship between statistically significant changes in lifestyle and eating habits and the shift of the tumor location to the right side, to provide theoretical basis for the relationship between the characteristics change of colorectal cancer and changes in lifestyle and eating habits. Materials and methods With a colonoscopy-based case-control study, Univariate analysis of logistic regression model was used to select significant factors, then the data were brought into multivariate analysis of logistic regression model. Obtained by multivariate analysis, and chi-square test was uesd to analyze those statistically significant factors are related to colorectal cancer onset right shift position. Results Age(OR 1.861,95%CI 1.795-1.932), body mass index increased(OR 5.056,95%CI 1.714-14.915), favoring to eat fat(OR 5.856,95%CI 3.484-8.276), often eat