评估40岁以下直肠出血患者结肠镜检查的必要性:从大规模的回顾性分析中得出的见解
Ibrahim M Obeidat1, Yousef Yahia2, Prem Chandra3
1Gastroenterology and Hepatology Department, Hamad Medical Corporation, Doha, Qatar. IObeidat@hamad.qa.
40岁以下患有直肠出血的患者的结肠镜检查发现显著的结肠直肠癌和晚期腺瘤息肉,特别是在年轻人中. 家庭病史是关键的危险因素,需要有针对性的查.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 在瘤学瘤学.
背景情况:
- 直肠出血是一种常见的症状.
- 结肠镜检查是45岁以上患者的标准检查,但其在年轻人中的作用尚不清楚.
- 这项研究检查了40岁以下的患有直肠出血的患者的结肠镜的适当性.
研究的目的:
- 评估40岁以下的患有直肠出血 (BPR) 患者结肠镜的适当性.
- 在这个人口群体中分析结肠镜检查结果和组织病理学.
- 识别与重大发现相关的风险因素.
主要方法:
- 在10年内进行的回顾性观察研究.
- 包括3422名年龄在18-40岁之间的患者,他们接受了针对BPR的结肠镜检查.
- 患者分为18-30岁和31-40岁的年龄组进行分析.
主要成果:
- 是最常见的 (48%),在年轻人群中更高 (50.7%).
- 在12.5%的患者中发现了多胞;在1.75%的患者中发现了先进的腺瘤多胞 (AAP);在1.3%的患者中发现了结直肠癌 (CRC).
- 家庭CRC/AAP病史显著增加了CRC风险 (aOR 6.35).
结论:
- 显著的发现,包括AAP和CRC,在40岁以下的患者中发现了显著的比例.
- 年轻的患者 (18-30岁) 显示出严重病变的显著检测率.
- 基于家族病史等风险因素的有针对性的结肠镜检查对于这个年龄组至关重要.
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