RESUMO
Objective To explore the endoscopic and histopathological features of serrated adenomas (SAs).Methods The data of patients with colorectal polyps diagnosed in the Digestive Endoscopy Center at Nanfang Hospital from January 2002 to July 2005 were reviewed and the detection rate, endoscopic appearances, pit patterns and histopathological features of SAs were analyzed.Results In 1928(16.21%) out of 11 894 patients undergoing colonscopy 2811 polyps were found.Among them 61 patients with 71 polyps were found,with a detection rate of 0.51%.The SAs,larger than hyperplastic polyps obviously,were found in patients 39.44% with diameter (larger than 1 cm).The incidence of pedunculated polyps in SAs (26.76%) was higher than that in hyperplastic polyps(13.25%),but less than in adenomatous polyps (43.95%).The pit patterns of SAs, were typeⅢ pit pattern (41.67%) and type Ⅳ pit pattern (18.33%), this result was similar to adenomatous polyps.The incidences of moderate and severe dysplasia of SAs were higher than those of tubular adenomas but lower than villous adenomas.The canceration rate of SA was 2.82%.Conclusion The endoscopic appearances,these of pit patterns and histopathological features of SAs,were different from hyperplastic polyps essentially, but similar to neoplastic polyps with potential malignancy,which should be emphasized in clinical practice.
RESUMO
0. 05 ) , but the control group had(P
RESUMO
Objective To alleviate or prevent the complication of propoful sedation and anesthesia during gastroscopy. Methods One thousand three hundred and fifty eight patients were undergone gastrosco-py under propoful sedation and anesthesia. Results Although some patients with intravenous use of propofol their blood pressure, heart and respiratory rate decreased in different extents, but others remained in normal range. During the operation, two cases(0. 15% )had hypotension which could be corrected after intravenous use of ephetonin; three cases (0. 22% ) had bradycardia that was restored after intravenous use of atropine; three hundred and eighteen cases (23. 42% )had cough which could be prevented by increasing the first dose of propofol and avoiding the pharyngeal simulation derived from operation; sixteen cases( 1. 18% )had serious chock accompanied with decreasing of blood oxygen saturation which could be alleviated by aspirating the guttural secretion, driving up the patients mandible and increasing oxygen inhalation, keeping the gastroscope dry and avoiding pumping water or air as passing through epiglottis are the effective methods in preventing chock. Forty six cases (3. 39% ) complained of pain in the injection site which could be alleviated by choosing a major vein and injecting drug slowly; forty three cases(3. 17% ) had nausea and two cases(0. 15% ) had phreno muscular spasm which could be alleviated or prevented by skilled manipulation; thirty nine cases (2. 87% )had vertigo after regaining consciousness, keeping in bed or deferring to wake the patient up are very effective in preventing and alleviating this symptom. Conclusion Although gastroscopy under propoful' s sedation and anesthesia is safe and effective, logical precautions are the keys to attain success and lessen complications.