| 摘要: |
| ［摘要］ 目的 分析儿童结直肠幼年性息肉（JP）临床特征及内镜下黏膜切除术(EMR)治疗该病的疗效。方法 回顾性分析2017年1月至2021年5月柳州市妇幼保健院收治的40例JP患儿的临床资料。其中男31例，女9例；年龄7个月～12岁，中位年龄5岁。均为结直肠单发JP。对其临床特征和治疗预后进行总结。结果 40例JP生长部位在直肠23例(57.50%)，乙状结肠12例(30.00%)，降结肠3例(7.50%)，横结肠1例(2.50%)，升结肠1例(2.50%)。息肉直径≤0.5 cm者2例(5.00%)，0.6～1.0 cm者17例(42.50%)，1.1～2.0 cm者15例(37.50%)，>2.0 cm者6例(15.00%)。直径最小为0.5 cm，最大为5.0 cm。山田分型为Ⅳ型19例(47.50%)，Ⅲ型11例(27.50%)，Ⅱ型9例(22.50%)，Ⅰ型1例(2.50%)。40例标本中有17例(42.50%)提示有慢性炎症改变，18例(45.00%)见小脓肿形成，未发现不典型增生及息肉恶变情况。本组患儿除2例术后10 d内偶有少量便血外，其余均无感染、穿孔及大出血等严重并发症发生，2个月后临床症状均消失。9例轻度贫血患儿术后2个月复查血红蛋白均恢复正常。22例术后复查肠镜，未见复发。结论 儿童结直肠JP好发于直肠、乙状结肠，EMR+金属夹治疗JP安全性高，疗效好，值得临床推广应用。 |
| 关键词: 儿童 幼年性息肉 临床特征 内镜下黏膜切除术 |
| DOI：10.3969/j.issn.1674-3806.2022.11.16 |
| 分类号:R 725.7 |
| 基金项目:广西卫生健康委科研项目（编号：Z20180020） |
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| Clinical features and therapeutic prognosis analysis of 40 children with colorectal juvenile polyps |
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QIN Yi, KONG Hong-xiang, YE Hui-lan, et al.
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Department of Gastroenterology, Liuzhou Maternity and Child Healthcare Hospital(Affiliated Maternity Hospital and Children′s Hospital of Guangxi University of Science and Technology), Guangxi 545001, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical features of colorectal juvenile polyp(JP) in children and the efficacy of endoscopic mucosal resection(EMR) in the treatment of JP. Methods The clinical data of 40 children with JP admitted to Liuzhou Maternity and Child Healthcare Hospital from January 2017 to May 2021 were retrospectively analyzed. Among the 40 children, there were 31 males and 9 females. The age of the 40 children ranged from 7 months to 12 years, with a median age of 5 years. All the patients had a single colorectal JP. The clinical features and therapeutic prognosis of the patients were summarized. Results Among the 40 cases, the growth site of JP was in the rectum in 23 cases(57.50%), in the sigmoid colon in 12 cases(30.00%), in the descending colon in 3 cases(7.50%), in the transverse colon in 1 case(2.50%), and in the ascending colon in 1 case(2.50%). There were 2 cases(5.00%) with diameter of polyps ≤0.5 cm, 17 cases(42.50%) with diameter of polyps from 0.6 cm to 1.0 cm, 15 cases(37.50%) with diameter of polyps from 1.1 cm to 2.0 cm, and 6 cases(15.00%) with diameter of polyps >2.0 cm. The minimum diameter was 0.5 cm and the maximum diameter was 5.0 cm. Yamada classification was type Ⅳ in 19 cases(47.50%), type Ⅲ in 11 cases(27.50%), type Ⅱ in 9 cases(22.50%), and type Ⅰ in 1 case(2.50%). Among the 40 specimens, 17 cases(42.50%) had chronic inflammatory changes in their specimens; 18 cases(45.00%) had small abscesses in their specimens, and no atypical hyperplasia and cancerous polyps were found. None of the pediatric patients in this group had serious complications such as infection, enterobrosis and massive hemorrhage, except for 2 cases who occasionally had a small amount of hemafecia within 10 days after surgery, and all the clinical symptoms disappeared 2 months later. The hemoglobin of 9 pediatric patients with mild anemia returned to normal 2 months after surgery. Twenty-two cases underwent reexamination with colonoscopy after surgery, and no recurrence was found. Conclusion Colorectal juvenile polyps in children are most likely to occur in the rectum and sigmoid colon. EMR plus metal clip has high safety and good efficacy in the treatment of JP, which is worthy of clinical application. |
| Key words: Children Juvenile polyp(JP) Clinical feature Endoscopic mucosal resection(EMR) |
