CAJ | 학술논문

目的：探讨全结肠结肠镜检查对儿童结肠息肉的诊断及治疗意义。方法2003年1月至2013年12月我们收治590例结肠息肉患儿，回顾性分析其临床特点及诊疗经过。结果590例患儿中，男性患儿较多（男∶女＝2∶1），平均年龄（4．7±2．5）岁，绝大多数患儿以大便带血为主要症状（554例，94％），部分患儿伴有其他症状，如反复发作性腹痛（51例，8．6％），息肉经肛门脱出（52例，8.8％）以及腹泻（12例，2．1％）。40例患儿（6．8％）有贫血，其中4例重度贫血患儿结肠镜检查前予输血治疗。本组单发息肉522例（88．5％），多发息肉68例（11．5％）。息肉位于乙状结肠272例（46.1％），直肠224例（38．0％），其余结肠94例（16．0％）。仅4例发生并发症（4／590），包括2例结肠穿孔，2例出血，经治疗后均痊愈。病理学分析结果：幼年性息肉544例（92．2％），Peutz-Jeghers 息肉20例（3．4％），幼年性息肉病17例（2．9％），错构瘤7例（1．2％），家族性腺瘤性息肉病1例（0．17％），炎性息肉1例（0．17％）。结论结肠息肉是儿童便血的常见原因之一，息肉可分布在结、直肠全程。儿童出现下消化道出血症状，全结肠结肠镜检查是必要的，可以直接诊断和治疗结肠息肉，并对炎性肠病等疾病起到协助诊断的作用。
목적：탐토전결장결장경검사대인동결장식육적진단급치료의의。방법2003년1월지2013년12월아문수치590례결장식육환인，회고성분석기림상특점급진료경과。결과590례환인중，남성환인교다（남∶녀＝2∶1），평균년령（4．7±2．5）세，절대다수환인이대편대혈위주요증상（554례，94％），부분환인반유기타증상，여반복발작성복통（51례，8．6％），식육경항문탈출（52례，8.8％）이급복사（12례，2．1％）。40례환인（6．8％）유빈혈，기중4례중도빈혈환인결장경검사전여수혈치료。본조단발식육522례（88．5％），다발식육68례（11．5％）。식육위우을상결장272례（46.1％），직장224례（38．0％），기여결장94례（16．0％）。부4례발생병발증（4／590），포괄2례결장천공，2례출혈，경치료후균전유。병이학분석결과：유년성식육544례（92．2％），Peutz-Jeghers 식육20례（3．4％），유년성식육병17례（2．9％），착구류7례（1．2％），가족성선류성식육병1례（0．17％），염성식육1례（0．17％）。결론결장식육시인동편혈적상견원인지일，식육가분포재결、직장전정。인동출현하소화도출혈증상，전결장결장경검사시필요적，가이직접진단화치료결장식육，병대염성장병등질병기도협조진단적작용。
Objetive The purpose of this report was to describe a clinical experience with colorectal polyps and to evaluate the diagnostic and therapeutic value of full colonoscopy to colorectal polyps in children. Methods This was aretrospective medical record review of 590 children with colorectal polyps managed be-tween 2003 to 201 3.Results The mean age at presentation was 4.7 ±2.5 years,with a male predominance (M/F ratio,2 ∶1 ).Most children (n =554,94%)presented with hematochezia associated with other symp-toms,such asrecurrent abdominal pain (n =51 ,8.6%),prolapsed of the polyp from the anus (n =52, 8.8%),and diarrhea (n =1 2,2.1 %).Anemia was found in 40 (6.8%)children,4 of whom required a blood transfusion before the colonoscopy.The most Polyp was solitary(n =522,88.5%),and others were pi-losity (n =68,1 1 .5%).The most common polyp locations were the sigmoid colon (n =272,46.1 %)and the rectum (n =224,38.0%),others (n =94,1 6.0%).Colonoscopy complications were rare,with colonic perfo-ration found in 2 patients and postcolonoscopy hemorrhage found in 2 patients.The pathology records showed that the most frequent histological type was juvenile polyps (n =544,92.2%),Peutz-Jeghers polyps (n =20, 3.4%),juvenile polyposis (n =1 7,2.9%),hamartomas (n =7,1 .2%),familial adenomatous polyposis (n =1 ,0.1 7%),and inflammatory polyps (n =1 ,0.1 7%). Conclusions Colorectal polyp is one of the pathogenesis in children with hematochezia.The colorectal polyps can be everywhere in whole course of colon and rectum.It is necessary to get a full colonoscopy to diagnose and remove the polyps in the cases of hema-tochezia in children.As well,it is conducive to diagnose the inflammatory bowel disease (IBD)or others.