Kemppainen M, Räihä I, Rajala T, Sourander L
Department of Geriatrics, University of Turku, Finland.
Age Ageing. 1993 Jul;22(4):260-4. doi: 10.1093/ageing/22.4.260.
The medical histories of 178 colorectal cancer patients were studied retrospectively from hospital records. The average age at the time of diagnosis was 71 years. Visible loss of blood or anaemia were the commonest features. The mean time from first symptom to first medical consultation was 82.8 days. Men under 65 years and women over 80 years waited the longest time before consulting a physician. The mean time from the first medical consultation to diagnosis was 44.7 days. The delay was longer for men than for women but longest for women aged over 80 years. Information about digital rectal examination was lacking in over half of all patients and in two-thirds of patients over 80 years. In patients in whom rectal examination had been made, as many as 60% of rectal cancers were digitally palpable. Barium enema missed the cancer diagnosis in 11.2% of patients at the first examination; the missed cancers were located in the sigmoid area and in the right colon. Colonoscopy can be recommended as the primary investigation method when colorectal cancer is suspected. Re-examination is necessary in elderly patients with sideropenic anaemia if the first examination is negative.
我们从医院记录中对178例结直肠癌患者的病史进行了回顾性研究。诊断时的平均年龄为71岁。肉眼可见的便血或贫血是最常见的特征。从出现首发症状到首次就医的平均时间为82.8天。65岁以下男性和80岁以上女性在就医前等待的时间最长。从首次就医到诊断的平均时间为44.7天。男性的延迟时间比女性长，但80岁以上女性的延迟时间最长。超过一半的患者以及三分之二的80岁以上患者缺乏直肠指检的相关信息。在进行了直肠检查的患者中，多达60%的直肠癌可通过直肠指检触及。钡剂灌肠在首次检查时漏诊了11.2%的患者；漏诊的癌症位于乙状结肠和右半结肠。当怀疑结直肠癌时，可推荐结肠镜检查作为主要的检查方法。如果首次检查结果为阴性，对于患有缺铁性贫血的老年患者有必要进行复查。
