结直肠腺瘤住院患者胃镜检查的临床资料分析（附1 052例报告）

Analysis of clinical data of gastroscopy in 1,052 hospitalized patients with colorectal adenoma

摘要:

目的 分析1 052例结直肠腺瘤住院患者行胃镜检查的资料，以期为结直肠腺瘤患者上消化道黏膜病变的早期发现和治疗提供参考依据。方法 回顾性分析2023年1月1日－2023年12月31日在九江学院附属医院消化内科住院的1 052例结直肠腺瘤患者的临床资料，分析患者临床表现、结肠镜结果、胃镜结果和疾病类型分布。结果 1 052例患者均伴随消化不良、胃肠道功能异常、胃食管反流和消化道出血症状，均检查出上消化道黏膜疾病，检出率为100.00%，192例（18.25%）患者只有1个胃镜诊断结果，860例（81.75%）患者有2个或2个以上诊断结果。共检出1 881处病变，以胃黏膜病变为主，其次为食管黏膜病变和十二指肠黏膜病变。前三检出疾病分别为：慢性非萎缩性胃炎932处，胃黏膜糜烂和/或胃肠上皮化生344处，以及胃息肉219处。不同性别疾病类型分布特点：大部分男性食管黏膜病变、胃黏膜病变和十二指肠黏膜病变占比高于女性，男性食管炎占比高于女性；不同年龄段疾病类型分布特点：年龄 > 45岁的患者胃息肉增多；Kaplan-Meier生存曲线显示，与未行胃镜检查的结直肠腺瘤患者相比，行胃镜检查的结直肠腺瘤患者无复发时间更长（HR＾ = 13.103，95%CI：6.589～26.057，P < 0.01）。结论 结直肠腺瘤患者建议行胃镜检查，以明确是否存在上消化道黏膜疾病。 > 45岁和男性为高风险人群，建议定期检查，通过早期发现和治疗，预防此类人群上消化道黏膜病变的发生。

Abstract:

Objective By analyzing the data of 1,052 inpatients with colorectal adenoma who underwent gastroscopy, it was expected to provide a reference basis for the early detection and treatment of upper gastrointestinal mucosal lesions in patients with colorectal adenoma.Methods Retrospective analysis was conducted on the clinical data of 1 052 patients with colorectal adenoma from January 1, 2023 to December 31, 2023. The clinical manifestations, colonoscopy results, gastroscopy results and the distribution of disease types of the patients were analyzed.Results All 1 052 patients were accompanied by symptoms of dyspepsia, abnormal gastrointestinal function, gastroesophageal reflux and gastrointestinal bleeding. Upper gastrointestinal mucosal diseases were all detected, with a detection rate of 100.00%. Among them, 192 patients (18.25%) had only one gastroscopy diagnosis result, and 860 patients (81.75%) had two or more diagnosis results. A total of 1,881 lesions were detected, the main disease was gastric mucosal lesions, followed by esophageal mucosal lesions and duodenal mucosal lesions. The top three detected diseases were chronic non-atrophic gastritis with 932 lesions, gastric mucosal erosion and/or metaplasia of the gastrointestinal epithelium with 344 lesions, and gastric polyps with 219 lesions. Distribution characteristics of disease types in different genders: the proportion of esophageal mucosal lesions, gastric mucosal lesions and duodenal mucosal lesions in most men was higher than that in women, and the proportion of esophagitis in men was significantly higher than that in women. Distribution characteristics of disease types in different age groups: gastric polyps increase significantly in patients over 45 years old. The Kaplan-Meier survival curve showed that compared with colorectal adenoma patients who did not undergo gastroscopy, colorectal adenoma patients who underwent gastroscopy had a longer recurrence-free time (HR＾ = 13.103, 95%CI: 6.589 ~ 26.057, P < 0.01).Conclusion Patients with colorectal adenoma are recommended to undergo gastroscopy to determine whether there are upper gastrointestinal mucosal diseases. People > 45 years old and men are high-risk groups. It is recommended that they have regular check-ups. Through early detection and treatment, the occurrence of upper gastrointestinal mucosal lesions in such groups can be prevented.