Department of Surgery, Maaslandziekenhuis, Sittard, The Netherlands.
Colorectal Dis. 2010 Feb;12(2):109-13. doi: 10.1111/j.1463-1318.2008.01755.x. Epub 2008 Dec 18.
This study was performed to determine the probability of finding additional pathology, requiring treatment or follow-up, in patients referred with symptoms suggestive of haemorrhoids. Secondly, to determine, at what age a flexible sigmoidoscopy should be performed in these patients.
All patients referred for the treatment of haemorrhoids over a period of 5 years were prospectively included in a database. Data included patient characteristics, clinical information, histopathological analysis and the sigmoidoscopy results.
Haemorrhoids were present in 961 (95.6%) of 1005 patients. Of these patients, 692 (72.0%) patients were free from any additional pathology, 161 (16%) patients had diverticulosis, in 15 (1.5%) patients the sigmoidoscopy showed signs of colitis, 116 (11.5%) patients had polyps and a malignancy was present in eight (0.8%) patients. In the age group between 30-40 and 40-50, the presence of additional pathology increased significantly (P < 0.05). No malignancies were found under the age of 40.
The vast majority of patients referred for the treatment and analysis of haemorrhoids were free from any additional pathology. But, over the age of 40, the incidence of additional pathology increased significantly. Therefore, we suggest that a flexible sigmoidoscopy should be performed in all patients over the age of 40, with clinical signs of haemorrhoids.
本研究旨在确定因疑似痔疮症状而就诊的患者中发现需要治疗或随访的其他病理的可能性。其次，确定在这些患者中应在什么年龄段进行乙状结肠镜检查。
在 5 年期间，前瞻性地将所有因痔疮就诊的患者纳入数据库。数据包括患者特征、临床信息、组织病理学分析和乙状结肠镜检查结果。
在 1005 例患者中，961 例（95.6%）存在痔疮。其中，692 例（72.0%）患者无任何其他病理，161 例（16%）患者有憩室病，15 例（1.5%）患者的乙状结肠镜检查显示结肠炎迹象，116 例（11.5%）患者有息肉，8 例（0.8%）患者存在恶性肿瘤。在 30-40 岁和 40-50 岁年龄组中，额外病理的存在显著增加（P<0.05）。40 岁以下未发现恶性肿瘤。
因治疗和分析痔疮而就诊的绝大多数患者没有任何其他病理。但是，40 岁以上患者中，额外病理的发生率显著增加。因此，我们建议对有临床痔疮症状的所有 40 岁以上患者进行乙状结肠镜检查。
