發(fā)布時(shí)間：2019-05-28 00:37

【摘要】：目的:本研究分為兩部分,第一部分:探討高危因素問卷調(diào)查聯(lián)合糞隱血試驗(yàn)對大腸病變初篩意義及可行性;第二部分:大腸腫瘤的相關(guān)危險(xiǎn)因素分析。方法:第一部分:對2016年1月至2016年12月于延安大學(xué)附屬醫(yī)院就診的40-75歲患者及無癥狀體檢人群共計(jì)7200例,行大腸腫瘤危險(xiǎn)因素評估問卷調(diào)查及免費(fèi)糞隱血篩查試驗(yàn),對初篩陽性者,進(jìn)一步行結(jié)腸鏡檢查,匯總篩查結(jié)果,進(jìn)一步分析。第二部分:對2012年1月至2016年12月于我院行結(jié)腸鏡及病理組織學(xué)診斷為大腸癌患者427例,大腸腺瘤患者816例及同時(shí)段行結(jié)腸鏡檢查診斷為正常者,采用面對面調(diào)查及電話詢問等兩種方式完成高危因素問卷調(diào)查,對納入資料行1:1病例-對照研究,并進(jìn)行相關(guān)分析。結(jié)果:1.問卷調(diào)查陽性人群與問卷調(diào)查陰性人群糞隱血陽性率有顯著性差異(X2=22.339,p0.05)。2.單純問卷調(diào)查陽性者798例,接受結(jié)腸鏡檢查者359例,依從性44.99%,結(jié)腸病變檢出率34.82%;單純糞隱血陽性者24例,行結(jié)腸鏡精篩者10例,依從性41.67%,病變檢出率20.00%;初篩雙陽性者29例,精篩依從性96.55%,結(jié)腸病變檢出率為46.43%。三組病變檢出率比較無顯著性意義(x2=2.581,p=0.275)。3.對大腸癌組和對照組可能的易感及危險(xiǎn)因素進(jìn)行多因素Logistic回歸分析結(jié)果顯示:與少食或不食高脂類食品、腌制食品等相比,經(jīng)常食此類物質(zhì)的人患大腸癌風(fēng)險(xiǎn)增加,2型糖尿病、膽囊結(jié)石是大腸癌的危險(xiǎn)因素,有下腹痛及慢性腹瀉等臨床癥狀表現(xiàn)的與大腸癌發(fā)生有相關(guān)性。4.對大腸腺瘤組和對照組可能的易感及危險(xiǎn)因素進(jìn)行多因素Logistic回歸分析結(jié)果顯示:經(jīng)常食腌制類物質(zhì)的人患大腸腺瘤風(fēng)險(xiǎn)增加,C型性格、吸煙史、家族史是大腸腺瘤的危險(xiǎn)因素,慢性便秘與大腸腺瘤發(fā)生相關(guān)。結(jié)論:1.伺機(jī)性篩查可能為延安地區(qū)大腸腫瘤初篩較合理的模式。2.危險(xiǎn)因素問卷調(diào)查及糞便潛血試驗(yàn)作為傳統(tǒng)的大腸病變初篩方法依然有效,且在普通腸道病變的預(yù)示作用中,兩者無明顯差異。3.對于平均風(fēng)險(xiǎn)人群,伺機(jī)性篩查可早期檢出大腸癌及相關(guān)癌前病變,對疾病盡早干預(yù)、改善結(jié)直腸癌的預(yù)后有重要意義。4.大腸癌危險(xiǎn)因素有:經(jīng)常食高脂類食品、腌制食品;有2型糖尿病病史、膽囊結(jié)石史;存在下腹痛及慢性腹瀉等消化道臨床癥狀。5.經(jīng)常食腌制食品、C型行為類型、吸煙史、大腸腫瘤家族史及長期慢性便秘等為大腸腺瘤發(fā)生的危險(xiǎn)因素。
[Abstract]:Objective: this study is divided into two parts: the first part: to explore the significance and feasibility of high risk factors questionnaire survey combined with fecal occult blood test for screening colorectal lesions; the second part: analysis of related risk factors of colorectal tumors. Methods: the first part: a total of 7200 patients aged 40 years and 75 years old and asymptomatic physical examination in the affiliated Hospital of Yan'an University from January 2016 to December 2016 were investigated by questionnaire on the risk factors of colorectal tumors and free fecal hidden blood screening test. For those who were positive for primary screening, colonoscopy was further performed, the screening results were summarized and further analyzed. Part II: from January 2012 to December 2016, 427 patients with colorectal cancer, 816 patients with colorectal adenoma and 816 patients with colorectal adenoma were diagnosed as normal by colonoscopy and pathology in our hospital. Face-to-face survey and telephone inquiry were used to complete the questionnaire survey of high risk factors. The 1:1 case-control study was included in the data, and the correlation analysis was carried out. Result: 1. There was significant difference in the positive rate of fecal occlusive blood between the positive population and the negative group (X2 鈮，

本文編號：2486575