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儿童期的幼年性息肉与结肠镜下息肉切除术

Juvenile polyp and colonoscopic polypectomy in childhood.

作者信息

Lee Byung Gee, Shin Sung Hyun, Lee Young Ah, Wi Joo Hee, Lee Yeoun Joo, Park Jae Hong

机构信息

Department of Pediatrics, Good Gang-An Hospital, Busan, Korea.

出版信息

Pediatr Gastroenterol Hepatol Nutr. 2012 Dec;15(4):250-5. doi: 10.5223/pghn.2012.15.4.250. Epub 2012 Dec 31.

Abstract

PURPOSE

This study aimed to evaluate the clinical features of juvenile polyp and the usefulness of polypectomy with entire colonoscopy in children.

METHODS

We retrospectively reviewed the medical records of 83 children who were diagnosed with having juvenile polyps.

RESULTS

The mean age of the patients was 6.5±3.7 (range 1.3-14.5 years) years. The male to female ratio was 2.1: 1. Eighty one patients (97.6%) had hematochezia, of which the observed characteristics included red stool (74.1%), blood on wipe (13.6%). The time interval between the 1st episode of hematochezia and colonoscopy was 8.9±20.4 (ranged 0.1-48.0) months. The most proximal regions of colonoscopic approach were terminal ileum (96.4%). Sixty three patients (75.9%) had a solitary polyp and 20 patients (24.1%) had multiple polyps. The sites of the polyps were rectum (61.4%), sigmoid colon (23.5%). Eighteen polyps (15.1%) were found more proximal locations than rectosigmoid. The polyp size ranged from 0.3 to 5 cm. After the polypectomy, hematochezia recurred in 9 patients. Endoscopic hemostasis was performed in 2 patients due to severe bleeding. All procedures were carried out without using general anesthesia.

CONCLUSION

Juvenile polyp occurred in a wide range locations and had variable sizes and numbers, suggesting that colonoscopy on the entire colon is necessary. Colonoscopic polypectomy is a simple and useful therapeutic method in children with juvenile polyp.

摘要

目的

本研究旨在评估儿童幼年性息肉的临床特征以及全结肠镜下息肉切除术在儿童中的实用性。

方法

我们回顾性分析了83例诊断为幼年性息肉的儿童的病历。

结果

患者的平均年龄为6.5±3.7岁(范围1.3 - 14.5岁)。男女比例为2.1:1。81例患者(97.6%)有便血,观察到的特征包括红色粪便(74.1%)、擦拭带血(13.6%)。首次便血发作至结肠镜检查的时间间隔为8.9±20.4个月(范围0.1 - 48.0个月)。结肠镜检查最接近的部位是回肠末端(96.4%)。63例患者(75.9%)有单个息肉,20例患者(24.1%)有多个息肉。息肉部位为直肠(61.4%)、乙状结肠(23.5%)。18个息肉(15.1%)位于直肠乙状结肠近端。息肉大小范围为0.3至5厘米。息肉切除术后,9例患者便血复发。2例患者因严重出血进行了内镜止血。所有操作均未使用全身麻醉。

结论

幼年性息肉发生部位广泛,大小和数量各异,提示有必要对全结肠进行结肠镜检查。结肠镜下息肉切除术是治疗儿童幼年性息肉的一种简单且有用的方法。

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