Đặc điểm nội soi đại tràng và mô bệnh học ở bệnh nhân có triệu chứng của hội chứng ruột kích thích theo Rome IV

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Phạm Phương Thư Trần, Thị Khánh Tường Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 616.34 *Diseases of intestine

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 45297

Bộ sưu tập: Metadata

ID: 499414

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Chủ đề

Describe symptoms, colonoscopy results, pathology (if available) of the group of patients with or without alarm features according to ROME IV criteria and identify some risk factors in the group of patients with colorectal advanced neoplasms. Subjects and methods: Cross - sectional study, recording symptoms and colonoscopy results of patients 18 years and older underwent colonoscopy at with IBS-like symptoms. Results: We collected 265 cases completed colorectal endoscopy: 163 patients (61,5%) have ROME IV IBS-like symptoms
41,72% of them had normal colonoscopy result
95 cases had lesion, include: 33,74% colitis, 9,82% adenoma and 3,68% colorectal cancer. In the group of patients not having any alarm features, the rate of anatomic abnormalities was low, and no colorectal advanced neoplasms was recorded. The predictive models for colorectal advanced neoplasms are: (1) age, rectal bleeding, weight loss (OR: 1,07, 10,47 and 7,74)
(2) rectal bleeding, weight loss and APCS score (OR: 7,47, 1,41 and 2). Conclusion: In the group of patients with no alarm features, the majority has normal colonoscopy results. Rate of colorectal advanced neoplasms is low in IBS-like symptoms
but all of them have alarm features and high APCS score. Therefore, before diagnosing IBS, we suggest that attention should be paid to eliminate these risk factors.Mô tả đặc điểm lâm sàng, nội soi đại trực tràng, mô bệnh học (nếu có) trên nhóm bệnh nhân có và không có triệu chứng báo động theo ROME IV và xác định một số yếu tố nguy cơ trên nhóm bệnh nhân có tổn thương u tân sinh nguy cơ cao. Đối tượng và phương pháp: Nghiên cứu cắt ngang, ghi nhận triệu chứng lâm sàng và kết quả nội soi đại trực tràng của những bệnh nhân ≥ 18 tuổi đã được nội soi và có triệu chứng của HCRKT theo ROME IV. Kết quả: Chúng tôi ghi nhận 265 ca được nội soi đến manh trành, có 163 trường hợp (61,5%) có triệu chứng của HCRKT theo ROME IV. Kết quả nội soi đại trực tràng ghi nhận: 41,72% bệnh nhân không có tổn thương và 95 trường hợp có tổn thương (33,74% viêm/loét, 9,82% polyp tuyến và 3,68% trường hợp ung thư đại trực tràng). Trong nhóm bệnh nhân không có triệu chứng báo động, tỷ lệ tổn thương sau nội soi đại tràng thấp và không ghi nhận u tân sinh nguy cơ cao. Mô hình dự đoán nguy cơ tổn thương u tân sinh nguy cơ cao là gồm: (1) tuổi, tiêu máu và sụt cân (OR: 1,07, 10,47 và 7,74)
(2) tiêu máu, sụt cân và điểm Asian - Pacific Colorectal Screening (OR: 7,47, 1,41 và 2). Kết luận: Trong nhóm bệnh nhân không có triệu chứng báo động, đa số không có tổn thương hoặc không có tổn thương u tân sinh nguy cơ cao. Tỷ lệ u tân sinh nguy cơ cao trong nhóm bệnh nhân HCRKT chiếm tỷ lệ thấp, nhưng tất cả bệnh nhân đều có triệu chứng báo động và điểm APCS cao. Vì vậy, trước chẩn đoán HCRKT cần chú ý loại trừ những yếu tố nguy cơ này.

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