本文選題：胃息肉 + 病理類型　； 參考：《大連醫(yī)科大學》2017年碩士論文

【摘要】：目的通過收集大連醫(yī)科大學附屬第一醫(yī)院消化內(nèi)科胃息肉住院患者的臨床資料與輔助檢查,胃息肉在內(nèi)鏡下的表現(xiàn)以及病理結(jié)果,分析近幾年胃部息肉的臨床特點及針對病理類型的變化情況,為日后胃息肉的預(yù)防、診斷以及選取合適的診療方法提供臨床參考。資料與方法1.研究對象大連醫(yī)科大學附屬第一醫(yī)院消化內(nèi)科從2014年1月到2016年12月期間住院的患者里面經(jīng)胃鏡探查并且完成病理活檢的息肉患者病例共628人。除外胃癌、黑斑息肉病(Peutz-Jeghers綜合征)、有胃部手術(shù)病史者及幼年性息肉病(Juvenile polyposis JPS)等其他情況。搜集患者個人資料、學歷、居住環(huán)境、伴隨其他系統(tǒng)疾病、相關(guān)輔助檢查及胃鏡和病理結(jié)果,胃鏡結(jié)果需詳細記錄病變的部位、數(shù)目、息肉最大徑(如為多發(fā)息肉則取最大者息肉的最大徑)、廣基或帶蒂、表面黏膜情況等。其中,男性患者共有146例,占總?cè)藬?shù)的23.2%,女性患者有482例,占總?cè)藬?shù)的76.8%,男女性別比值為1:3.13。入選患者的年齡范圍是21歲至86歲,本組病例的平均年齡為59.24歲。2.內(nèi)鏡檢查均由我院專業(yè)內(nèi)鏡醫(yī)師對受檢者食管及胃部各個部位進行全面仔細觀察,記錄息肉的一般情況,包括所在部位、息肉最大徑、隆起或扁平、數(shù)量及表面黏膜情況等。3.病理組織學檢查對于單發(fā)直徑小于等于3mm的胃息肉取材后直接電凝切除,大于3mm的息肉選取相應(yīng)措施摘除的同時鉗取小部分組織進行活檢,多發(fā)性胃息肉取代表性1-2塊組織進行活檢,以上組織均由我院病理科得出病理診斷。4.統(tǒng)計學處理收集的資料經(jīng)SPSS 21.0軟件處理分析,計量資料以X±S或中位數(shù)表示,計數(shù)資料不同類型用x2檢驗進行比較,P0.05為差異有統(tǒng)計學意義。結(jié)果1.本研究共納入628例患者,年齡最小21歲,最大86歲,平均年齡59.24歲。其中,女性患者和男性患者相比,發(fā)病年齡段不同,60歲的患者女性多發(fā),≥60歲患者中男性多發(fā),有統(tǒng)計學差異(X2=9.585,P=0.048)。男性占23.2%(146/628),女性占76.8%(482/628),男女比值約為1:3.301,女性占大多數(shù)。女性患者發(fā)病率與男性患者發(fā)病率相比較,女性患者在人數(shù)上明顯高于男性,差異有意義(X2=628,P0.001)。2.臨床癥狀主要有反酸(18.1%)、燒心(15.9%)、胸骨后燒灼感(或咽部梗咽感、吞咽困難)(3.7%)、消瘦、食欲不振(2%)、惡心嘔吐(5.2%)、腹痛(20.9%)、腹部不適(5.6%)等。3.單發(fā)息肉為333例(53.0%),多發(fā)息肉為295例(47.0%)。胃底腺息肉最多見(49%),其次是增生性息肉(35.7%)、炎性息肉(9.1%)、腺瘤性息肉(2.1%)及炎性纖維性息肉(1.3%)。≤0.5cm胃息肉最多見,占70.9%。4.山田分型Ⅰ型有133例,占21%;Ⅱ型有472例,占75.2%;Ⅲ型有21例,占3.3%;Ⅳ型有2例,占0.3%,Ⅰ型和Ⅱ型息肉占大多數(shù)。胃底和胃體是胃息肉最好發(fā)部位,占28.8%、36.6%。結(jié)論:胃息肉患者女性多發(fā);中老年人更多發(fā)胃息肉;胃體是息肉最常見的好發(fā)部位,其次分別是胃底、胃竇、賁門、胃角和幽門;在0.5cm的息肉最常見,≥2.0cm息肉少見;山田分型中Ⅱ型最常見;胃底腺息肉最常見,第二是增生性息肉,其他依次是炎性息肉、腺瘤性息肉、炎性纖維性息肉。胃底腺息肉多出現(xiàn)在胃底和胃體,增生性息肉大多數(shù)發(fā)生于胃體及胃竇部,炎性息肉于賁門和胃竇部位多發(fā),炎性纖維性息肉主要發(fā)生在胃竇部。
[Abstract]:Objective to analyze the clinical characteristics and pathological results of gastric polyps in recent years by collecting the clinical data and auxiliary examination of the patients with gastric polyps in the digestive department of the First Affiliated Hospital of Dalian Medical University, and to analyze the clinical characteristics of gastric polyps in recent years and the changes in the pathological types. The prevention, diagnosis and selection of the gastric polyps in the future are suitable for the prevention and selection of the gastric polyps. The method of diagnosis and treatment provides clinical reference. Data and methods 1. subjects of polyp patients who were hospitalized in the first hospital of the First Affiliated Hospital of Dalian Medical University from January 2014 to December 2016 were examined by gastroscopy and completed pathological biopsy, except for gastric cancer, Peutz-Jeghers syndrome, and stomach. Other cases, such as surgical history and juvenile polyposis (Juvenile polyposis JPS). Collection of personal data, educational background, living environment, accompanied by other systemic diseases, associated examination and gastroscopy and pathological results. The results of gastroscopy require detailed records of the site, number and maximum diameter of polyps (for example, multiple polyps are the largest polyps. " There were 146 cases in male patients, 23.2% of the total, 482 in women, 76.8% in the total, and the age range of 1:3.13. patients was 21 to 86 years old. The average age of this group was 59.24 years.2. endoscopy in our hospital. The normal observation of all parts of the esophagus and stomach of the subjects, the general situation of polyps, including the location of the polyps, the maximum diameter of polyps, the bulge or flattening, the number and the surface of the mucous membrane, were examined by.3. histopathological examination for the direct electrocoagulation of the gastric polyps with a single diameter of less than or equal to 3mm, and the selection of polyps greater than 3mm A small portion of the biopsy was taken while the corresponding measures were removed. The multiple gastric polyps were taken from 1-2 tissues for biopsy. All the above tissues were collected by the pathological diagnosis of.4. in our hospital. The data were analyzed by SPSS 21 software. The measurement data were expressed in X + S or median, and the different types of data were used in x2 The test was compared, and P0.05 was statistically significant. Results 1. of the 628 patients were included in the study. The age was 21 years old, the maximum age was 86 years, and the average age was 59.24 years old. Among them, the age of the patients and the male patients were different, the 60 years old were more frequent, and the males were more than 60 years old, and there were statistically significant differences (X2=9.585, P=0.048). Men accounted for 23.2% (146/628), women accounted for 76.8% (482/628), the ratio of men and women was about 1:3.301, and women accounted for the majority. The incidence of female patients was compared with the incidence of male patients. The number of female patients was significantly higher than that of men. The difference was significant (X2=628, P0.001).2. clinical symptoms were mainly anti acid (18.1%), heartburn (15.9%), and pharynx (or pharynx). (3.7%), 3.7%), thinness, anorexia (2%), nausea and vomiting (5.2%), abdominal pain (20.9%), abdominal discomfort (5.6%), 333 cases (53%), multiple polyps in 295 (47%). The most common polyps of the stomach (49%) were hyperplastic polyps (35.7%), inflammatory polyps (9.1%), adenomatous polyps (2.1%) and inflammatory polyps (5.6%). 1.3%) < < 0.5cm gastric polyps most see, accounting for 70.9%.4. mountain field type I type I type I have 133 cases, accounting for 21%; type II type 472 cases, 75.2%; type III type 21 cases, 3.3%; type I, 2 cases, 0.3%, type I and type II polyps accounted for most. The stomach fundus and stomach body is the best location of gastric polyps, 28.8%, 36.6%. conclusion: gastric polyps women often hair; middle old and old people are more hair. Gastric polyps are the most common location of polyps, followed by gastric fundus, antrum, cardia, gastric angle and pylorus. Polyps in 0.5cm are the most common and less than 2.0cm polyps are rare; the most common in the Yamada type are type II; the most common gastric fundus polyps, second are proliferative polyps, and the others are inflammatory polyps, adenomatous polyps, and inflammatory polyps. Most of the gastric fundus polyps occur in the fundus of the stomach and the body of the stomach. Most of the hyperplastic polyps occur in the gastric and gastric antrum, and inflammatory polyps occur frequently in the cardia and antrum, and inflammatory polyps mainly occur in the gastric antrum.

【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R573
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本文編號：1842711