Đặc điểm dịch tễ học và lâm sàng polyp đại trực tràng trẻ em tại bệnh viện Nhi Đồng 1

ÑAËC ÑIEÅM DÒCH TEÃ HOÏC VAØ LAÂM SAØNG POLYP ÑAÏI TRÖÏC TRAØNG<br /> TREÛ EM TAÏI BEÄNH VIEÄN NHI ÑOÀNG 1<br /> Phaïm Ñöùc Leã *, Voõ Coâng Ñoàng**, Nguyeãn Ñoã Nguyeân***<br /> <br /> TOÙM TAÉT<br /> Muïc tieâu: Xaùc ñònh tính giaù trò nhöõng ñaëc ñieåm dòch teã hoïc vaø laâm saøng treû maéc polyp ñaïi tröïc traøng.<br /> Phöông phaùp vaø Keát quaû: Nghieân cöùu caét ngang qua noäi soi ñaïi traøng 212 treû. Coù 104 treû maéc polyp.<br /> Tuoåi trung bình treû maéc polyp laø 5,7 tuoåi, Treû nam maéc polyp nhieàu hôn nöõ (tæ soá nam/nöõ 1,5/1). Soá treû<br /> maéc polyp nhieàu nhaát taïi tröïc traøng (64,4%) vaø ñaïi traøng sigma (35,6%), ít hôn taïi ñaïi traøng xuoáng<br /> (15,4%), ñaïi traøng ngang (7,7%), ñaïi traøng leân (7,7%) vaø manh traøng (5,8%). Khaûo saùt moâ hoïc 89 treû, loaïi<br /> polyp thieáu nieân chieám 93,2%, polyp tuyeán 3,4% vaø polyp Peutz-Jeghers 3,4%. Ñaëc ñieåm laâm saøng treû<br /> maéc polyp ñaïi tröïc traøng coù yù nghóa thoáng keâ: thôøi gian nhöõng ñôït tieâu maùu keùo daøi hôn moät tuaàn (OR =<br /> 7,47; 95% CI = 3,91 – 14,62; p = 0,00), thôøi gian giöõa caùc ñôït tieâu maùu ngöng döôùi moät tuaàn (OR = 8,33;<br /> 95% CI = 4,35 – 16,66; p = 0,00), veát maùu dính taïi choùp ñuoâi khuoân phaân (OR = 59,05; 95% CI = 22,89<br /> – 168,82; p = 0,00). Keát luaän: Nghieân cöùu cuûa chuùng toâi cho thaáy nhöõng treû maéc polyp ñaïi tröïc traøng coù<br /> bieåu hieän laâm saøng laø tieâu phaân coù veát maùu dính taïi choùp ñuoâi khuoân phaân, thôøi gian nhöõng ñôït tieâu maùu<br /> keùo daøi hôn moät tuaàn, thôøi gian giöõa caùc ñôït tieâu maùu ngöng döôùi moät tuaàn.<br /> <br /> SUMMARY<br /> EPIDEMIOLOGICAL & CLINICAL CHARACTERICTICS OF COLORECTAL POLYPS<br /> IN CHILDREN AT THE CHILREN HOSPITAL N° 1<br /> Pham Ñöc Le, Vo Cong Ñong, Nguyen Ño Nguyen<br /> * Y Hoc TP. Ho Chi Minh * Vol. 9 * Supplement of No 1 * 2005: 190 – 195<br /> <br /> Objective: To determine the validity of epidemiological and clinical characterictics of colorectal<br /> polyps in children. Methods: A crossectional study of all children under colonoscopy at the Chilren<br /> Hospital N° 1 during period 4/2003 – 4/2004. Results: There were totally 212 children performed by<br /> colonoscopy. Colorectal polyps were detected in 104 children, among them 89 children had their polyps<br /> investigated by histologic examination. Children with polyps were predominantly boy (male/female ratio<br /> was 1,5/1), with the mean age of 5,7 years old. Children had polyps mainly in rectum (with 64%), then<br /> subsequently in sigmoid colon (36,5%), descending colon (15,4%), transverse colon (7,7%), ascending<br /> colon (7,7%), and cecum (5,8%). In histology, the polyps were classified as juvenile in 93,2%,<br /> adenomatous in 3,4%, Peutz-Jeghers in 3,4%. Among various epidemiological and clinical characteristics,<br /> the statistically significant determinants of polyps were identified as (1) bloody streak at the end of faeces<br /> (OR = 59,05; 95% CI = 22,89 – 168,82; p = 0,00). (2) more-than-one-week duration of each bloody stool<br /> period (OR = 7,47; 95% CI = 3,91 – 14,62; p = 0,00), (3) less-than-one-week interval between bloody<br /> stool periods (OR = 8,33; 95% CI = 4,35 – 16,66; p = 0,00), Conclusions: Our study in children with<br /> many bloody stool periods showed that the significant determinants of colorectal polyps were bloody<br /> streak at the end of faeces, long bloody stool period (>1 week) and short interval between bloody stool<br /> periods (