本文關(guān)鍵詞：合肥市消化道癌篩查結(jié)果及影響因素分析　出處：《安徽醫(yī)科大學》2017年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 上消化道癌 結(jié)直腸癌 篩查 既往病史 飲食行為習慣

【摘要】：目的1)分析合肥市消化道(上消化道和結(jié)直腸)癌篩查結(jié)果,了解合肥市居民消化道健康狀況以及消化道癌前病變的分布和嚴重程度;2)分析消化道各部位病變的影響因素,為探索各部位病變發(fā)展規(guī)律和癌變可能性提供依據(jù)。方法采用整群抽樣方法在安徽省合肥市選擇7個區(qū),從每個區(qū)中隨機選取2-3個街道,對入選街道中40-70歲符合納入標準的居民通過問卷調(diào)查初步篩選出癌癥高危人群,然后對高危人群進行臨床癌癥篩查并再次進行慢性病問卷調(diào)查。數(shù)據(jù)錄入采用EpiData3.1軟件進行實時雙錄入和邏輯校驗,結(jié)果分析使用SPSS17.0軟件進行。通過描述性分析、卡方檢驗、單向有序秩和檢驗和logistic回歸分析進行消化道各部位影響因素分析。結(jié)果1)既完成上消化道鏡檢又完成慢性病調(diào)查的有1277人。食管病變檢出率隨年齡增大而升高,40-49歲組檢出率13.0%,50-59歲組18.4%,60-70歲21.2%。男性(21.2%)食管病變率高于女性(15.0%)。賁門部和胃底部病變檢出率在年齡、性別、文化程度和體質(zhì)指數(shù)各組間分布均無統(tǒng)計學差異。胃體病變檢出率隨年齡增長逐漸增加,40-49歲組、50-59歲組及60-70歲組病變檢出率分別為23.2%、31.2%和32.1%。胃角部病變檢出率男性為女性的2倍(男性為17.2%,女性為8.2%)。幽門部病變檢出率在不同體質(zhì)指數(shù)組間有統(tǒng)計學差異,體質(zhì)指數(shù)正常、超重及肥胖組的檢出率分別為9.38%、5.08%及9.40%。2)食管病變發(fā)生率最高的為糜爛,發(fā)生率為9.33%,其次為充血和粗糙或不規(guī)則,發(fā)生率分別為5.41%和2.43%。在賁門部,病變發(fā)生例數(shù)最多的為糜爛,其次為賁門息肉、腫物和充血。胃底部和胃體部病變發(fā)生率前3位為充血、息肉和水腫。胃角部前3位病變?yōu)槌溲�、水腫和糜爛。胃竇部最常見病變?yōu)槌溲?發(fā)生率高達88.89%。幽門部常見病變?yōu)槟懼街?)食管、賁門和胃底部病變得分最高4分,得分最多集中在1分。胃體、胃角、胃竇部最高得分5分。幽門部病變最高得分3分。4)賁門部病變得分與糖尿病患病率之間有統(tǒng)計學關(guān)聯(lián),但并不表現(xiàn)明顯趨勢,胃底病變得分與既往經(jīng)常胃痛之間有統(tǒng)計學關(guān)聯(lián),但并無明顯趨勢,胃體病變得分與高血脂、經(jīng)常失眠多夢和胃息肉有統(tǒng)計學聯(lián)系,胃角部病變得分與既往有胃潰瘍史和肝炎史有統(tǒng)計學關(guān)聯(lián),得分越高,既往有潰瘍史所占比例越高,但肝炎患病率與得分無明顯趨勢,胃竇部病變得分與高血壓、高血脂和既往潰瘍史之間有統(tǒng)計學差異,十二指腸部得分與既往胃炎和潰瘍史之間有統(tǒng)計學關(guān)聯(lián)。5)食道病變得分與經(jīng)常吃油炸食品、重鹽、經(jīng)常飲酒、經(jīng)常抽煙有統(tǒng)計學關(guān)聯(lián),得0分者中危險因素發(fā)生率均低于有得分者。胃體部病變得分與經(jīng)常飲酒具有統(tǒng)計學意義,且隨著病變得分越高,經(jīng)常飲酒率逐漸升高。胃角部病變得分與經(jīng)常吸煙、經(jīng)常飲酒有統(tǒng)計學聯(lián)系。胃竇部病變得分與經(jīng)常抽煙、飲酒、飲茶具有統(tǒng)計學意義。十二指腸病變得分與經(jīng)常飲食不規(guī)律有關(guān)。6)既完成結(jié)直腸鏡檢又完成慢性病問卷調(diào)查的有370人,結(jié)果發(fā)現(xiàn)左半結(jié)腸和直腸最易發(fā)生病變,且隨著年齡和體質(zhì)指數(shù)增加,病變發(fā)生率增加。7)結(jié)果表明年齡、體質(zhì)指數(shù)、自報既往高血壓史、腸息肉史和既往經(jīng)常便秘是結(jié)直腸病變的危險因素。結(jié)論1)在上消化道,食管和胃竇部最易發(fā)生病變,可視為上消化癌篩查的重點部位,且這些病變受多種既往病史和飲食行為習慣影響,通過既往病史和飲食行為習慣問卷調(diào)查初篩高危人群可行。2)在結(jié)直腸部,左半結(jié)腸和直腸最易發(fā)生病變,可視為腸鏡檢查的重點部位,通過既往疾病/癥狀史、飲食行為習慣與結(jié)直腸病變關(guān)系分析,提示通過既往病史初篩結(jié)直腸高危人群比較可信,但多種飲食行為習慣在結(jié)直腸癌篩查中的作用尚不明確。
[Abstract]:1) analysis of Hefei city in the digestive tract (upper gastrointestinal and colorectal cancer screening results), understand the Hefei city residents health status and distribution of digestive tract gastrointestinal precancerous lesions and severity; 2) analysis of gastrointestinal lesions of the effects of various factors, provide the basis for exploring the possibility of each part of the law of development and malignant lesions. Methods by cluster sampling method, 7 District in Anhui city of Hefei Province, were randomly selected from each district of 2-3 street, on the street in the selected 40-70 years in accordance with the inclusion criteria of residents by questionnaire survey screened cancer high-risk groups, and clinical cancer screening for high-risk patients and chronic disease questionnaire again. The data entry uses EpiData3.1 software for real-time double entry and logical verification, and the results are analyzed using SPSS17.0 software. The influence factors of various parts of the digestive tract were analyzed by descriptive analysis, chi square test, unidirectional order rank sum test and logistic regression analysis. Results 1) there were 1277 people who completed both the upper gastrointestinal endoscopy and the chronic disease investigation. The detection rate of esophageal lesions increased with age. The detection rate in the 40-49 year old group was 13%, the 50-59 year old group was 18.4%, and the 60-70 year old was 21.2%. The rate of esophageal lesion in men (21.2%) was higher than that of women (15%). There was no significant difference in the distribution of age, sex, educational level and body mass index between the cardia and the fundus of the stomach. The detection rate of gastric body lesions increased gradually with age. The detection rates of pathological changes in 40-49 year old group, 50-59 year old group and 60-70 year old group were 23.2%, 31.2% and 32.1%, respectively. The rate of detection of lesions in the angle of the stomach was 2 times as high as that of women (17.2% for men and 8.2% for women). The detection rate of pyloric lesions was statistically different among different body mass index groups. The detection rates of body mass index in normal, overweight and obesity groups were 9.38%, 5.08% and 9.40%, respectively. 2) the highest incidence of esophageal lesions was erosions, the incidence of which was 9.33%, followed by hyperemia, rough or irregular, and the incidence of 5.41% and 2.43%, respectively. In the cardia, the most of the cases were erosions, followed by cardia polyps, swelling and hyperemia. The first 3 were hyperemia, polyps and edema in the top of the gastric and gastric body lesions. The first 3 lesions of the horns of the stomach were hyperemia, edema and erosion. The most common lesion of the gastric antrum was hyperemia, and the incidence was up to 88.89%. The common lesion of the pylorus is bile attachment. 3) the highest score of the esophagus, the cardia and the bottom of the stomach was 4 points, with a score of 1 points at most. The highest score was 5 points in the stomach body, the angle of the stomach and the sinus of the stomach. The highest score of pylorus lesion was 3 points. 4) cardia lesions score and the prevalence of diabetes association was observed between, but not obvious trend between gastric lesion score was significantly associated with previous often stomach pain, but there is no obvious trend, there was correlation in gastric body lesion score and high blood lipids, often insomnia and gastric polyp and gastric lesions and the scores of the corner with a history of gastric ulcer history and the history of hepatitis was associated with higher scores, previous ulcer history proportion is higher, but the prevalence rate of hepatitis had no obvious trend and score, there was significant difference between gastric lesion score and hypertension, previous ulcer history, there was a correlation between the duodenum and previous scoring gastritis and ulcer history. 5) esophageal lesions score and often eat fried food, salt, often drinking, smoking was significantly associated, rates were lower than the score were risk factors in the 0 points. The score of gastric body lesion and regular drinking had statistical significance. With the higher score of the lesion, the frequent drinking rate increased gradually. The score of gastric corner lesions was associated with frequent smoking and frequent drinking. The score of the lesion of the gastric antrum was statistically significant to smoking, drinking and drinking tea. The score of duodenal disease is related to irregular diet. 6) 370 patients who completed both colorectal examination and chronic disease questionnaire were found to be most susceptible to lesions in the left colon and rectum, and increased with age and body mass index. 7) the results showed that age, body mass index, history of self reporting hypertension, history of intestinal polyps, and previous frequent constipation were risk factors for colorectal lesions. Conclusion 1) in the upper gastrointestinal tract, esophageal and gastric antrum are most susceptible to lesions, which can be regarded as the key part of the upper digestive tract cancer screening. These lesions are influenced by many past medical history and eating habits. Through the past medical history and eating habits and habits questionnaire, it is feasible to screen high-risk groups. 2) in colorectal, left colon and rectum were most prone to disease, colonoscopy can be regarded as the key part of the relationship between disease symptoms / history, eating habits and colorectal lesions analysis, prompted by a history of colorectal screening high-risk groups more credible, but a variety of eating habits in the role of screening for colorectal cancer it is not clear.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735

【參考文獻】

相關(guān)期刊論文 前10條

1 汪雯;李輝章;朱陳;孫校華;張美珍;王悠清;杜靈彬;;浙江省2014—2015年度居民癌癥風險評估及篩查結(jié)果分析[J];浙江醫(yī)學;2016年22期

2 張爾慶;戴丹;查震球;朱啟星;;安徽省2012年食管癌流行特征分析[J];中華疾病控制雜志;2016年11期

3 李燕;劉華章;林國楨;梁穎茹;王穗湘;李科;許歡;;廣州市2015年大腸癌篩查結(jié)果分析[J];中國腫瘤;2016年06期

4 楊曉明;賈曉東;沈冰;王妍敏;張欣;高文君;王春芳;;上海市靜安區(qū)大腸癌高危人群腸鏡篩查順應性的影響因素[J];環(huán)境與職業(yè)醫(yī)學;2016年05期

5 吳菲;劉霄宇;趙根明;徐望紅;;癌癥篩查成本效果評估的研究進展[J];中國腫瘤;2016年02期

6 文素英;陳瑜容;文政偉;;消化性潰瘍病人幽門螺旋桿菌感染知識調(diào)查及健康宣教策略[J];全科護理;2015年32期

7 黃明敏;江偉駿;周震宇;顧怡雯;;結(jié)直腸息肉患病的相關(guān)因素分析[J];上海預防醫(yī)學;2015年06期

8 宋玨;冉利梅;華玉淑;曹煜;莫瀾;沈璐;吳春維;詹潔;;幽門螺桿菌感染與體質(zhì)量指數(shù)、血脂、尿酸的相關(guān)性分析[J];中國臨床保健雜志;2015年02期

9 董敬蓉;;胃鏡檢查者對幽門螺旋桿菌感染知曉率調(diào)查[J];中國衛(wèi)生產(chǎn)業(yè);2015年09期

10 李衛(wèi)中;;老年人免疫系統(tǒng)改變的研究[J];中國老年保健醫(yī)學;2014年05期

相關(guān)重要報紙文章 前1條

1 李穎;;《中國城市癌癥早診早治項目》正式納入國家醫(yī)改重大專項[N];科技日報;2012年

相關(guān)博士學位論文 前1條

1 潘華;超重/肥胖、幽門螺桿菌感染與胃癌的關(guān)聯(lián)研究[D];蘭州大學;2014年

相關(guān)碩士學位論文 前1條

1 羅來盛;結(jié)腸息肉臨床病理特征和癌變相關(guān)危險因素研究[D];浙江大學;2016年

，

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