2 669例儿童肠息肉的临床特征及继发肠套叠的危险因素分析

Clinical features of intestinal polyps and risk factors for secondary intussusception in children: an analysis of 2 669 cases

摘要:

目的 探讨儿童肠息肉的临床特征及继发肠套叠的危险因素。 方法 回顾性收集2 669例肠息肉患儿的临床资料，根据是否继发肠套叠，分为肠套叠组（n=346）和非肠套叠组（n=2 323）。比较分析两组患儿的临床资料，采用多因素logistic回归分析儿童肠息肉继发肠套叠的危险因素。 结果 62.42%肠息肉患儿为学龄前儿童，男女比例2.08∶1，92.66%以便血起病，94.34%为左半结肠及直肠息肉。继发肠套叠346例，发生率为12.96%（346/2 669）。息肉越大、多发息肉（≥2个）、分叶形息肉是继发肠套叠的危险因素（分别OR=1.644、6.034、93.801，P<0.001）。 结论 儿童肠息肉好发于学龄前，男性多见，多数以便血起病，好发部位为左半结肠及直肠；息肉越大、多发息肉、息肉形态为分叶形，继发肠套叠的风险越高，需尽早内镜干预，以改善预后。 用格式：引用格式:中国当代儿科杂志，2022，24（5）：530-535

Abstract:

Objective To study the clinical features of intestinal polyps and the risk factors for secondary intussusception in children. Methods A retrospective analysis was performed for the medical data of 2 669 children with intestinal polyps. According to the presence or absence of secondary intussusception, they were divided into two groups: intussusception (n=346) and non-intussusception (n=2 323). Related medical data were compared between the two groups. The multivariate logistic regression analysis was used to identify the risk factors for secondary intussusception. Results Among the children with intestinal polyps, 62.42% were preschool children, and the male/female ratio was 2.08∶1; 92.66% had hematochezia as disease onset, and 94.34% had left colonic polyps and rectal polyps. There were 346 cases of secondary intussusception, with an incidence rate of 12.96% (346/2 669). Large polyps (OR=1.644, P<0.001), multiple polyps (≥2) (OR=6.034, P<0.001), and lobulated polyps (OR=93.801, P<0.001) were the risk factors for secondary intussusception. Conclusions Intestinal polyps in children often occur in preschool age, mostly in boys, and most of the children have hematochezia as disease onset, with the predilection sites of the left colon and the rectum. Larger polyps, multiple polyps, and lobulated polyps may increase the risk of secondary intussusception, and endoscopic intervention is needed as early as possible to improve prognosis. Citation:Chinese Journal of Contemporary Pediatrics, 2022, 24(5): 530-535