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研究生:陳雅玲
研究生(外文):Chen-Ya ling 陳雅玲
論文名稱:生活方式與飲食習慣與大腸息肉的相關性
論文名稱(外文):Correlation between lifestyle and eating habits with colorectal polyps
指導教授:林俊哲林俊哲引用關係
指導教授(外文):Chun-Che Lin
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:51
中文關鍵詞:生活方式飲食習慣大腸息肉
外文關鍵詞:lifestyleeat habitscolorectal polyps
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大腸直腸癌罹患人數居105年全國癌症死亡原因第三位、發生率有逐年升高的情形,但若能早期發現,早期治療,其治癒率是非常高的。近年來因國人生活習慣的改變及飲食習慣精緻化及西化,導致大腸內的息肉易演變成具有高度癌化風險的腺瘤性息肉。大腸息肉轉變成大腸癌所需時間,因致癌途徑的不同亦不同、罹癌時間亦不同、了解生活方式和飲食習慣與大腸息肉的相關性,以預防為前題找出與息肉有關的相關因子,希望有效預防息肉演變成大腸癌。
本研究利用大腸鏡檢查的就醫個案所收集的「大腸鏡檢查評估問卷資料」共442份。問卷設計係由腸胃科醫師專家整理出與大腸息肉相關的四大類危險因子,分別為第一類、基本資料,第二類、慢性病史,第三類、家族病史,第四類、生活習慣等。結果發現性別、年齡、身高、體重、腰圍、及身體質量指數、腰臀圍比與息肉有明顯相關。個案出現排便型態改變、有裡急後重症狀、有大腸息肉病史、脂肪肝、高血壓及高血脂等與息肉有明顯相關。本研究中發現個案如有抽煙、喝酒及嚼檳榔的習慣與大腸息肉有明顯相關性;即使個案戒煙1-5年,或已戒酒仍有較高的比例被診斷有大腸息肉。
在臨床上若能針對風險性較高的患者安排大腸鏡的檢查、以便早期發現結腸腫瘤進而進行切除、逹到次級預防大腸惡性腫瘤的發生或是及早診斷大腸惡性腫瘤早期接受治療。
Colorectal cancer, the number of deaths in 105 years the third cause of cancer deaths in Taiwan、The incidence rate has increased year by year,but if early detection, early treatment, the cure rate is very high。In recent years due to changes in people''s living habits and eating habits of refined and Westernized leading to large intestine polyps easily evolved into a high degree of cancer risk of adenomatous polyps。Colorectal polyps into colorectal cancer time,due to different carcinogenic routes are different,cancer time is also different,und- erstanding of lifestyle and eating habits and colorectal polyps related to the pr- evention of the premise to find the relevant factors related to polyps,Hoping to effectively prevent the evolution of polyps into colorectal cancer。
In this study,a total of 442 copies of the "Colonoscopy Examination Ass- essment of questionnaire data" were collected from the medical examination of colonoscopy。Questionnaire design by the Department of Gastroenterologists experts and coliform polyps related to the four major categories of risk factors namely,the first category,basic information;the second category,chronic history;the third category,family history;the fourth category,lifestyle。The results showed that gender、age、height、weight、waist circumference、and the body mass index,waist and hip circumference were significantly correlated with polyps。
Cases have change in bowel habits、rectal tenesmus、history of colorectal polyps、fatty liver、high blood pressure and high cholesterol and polyp were significantly related。In this study,it was found that cases such as smoking,drinking and chewing betel nut had a clear correlation with colorectal polyps。Even if the case quit smoking for 1 to 5 years,or have a high proportion of alcohol has been diagnosed with colorectal polyps。
If the clinical risk of patients with colorectal cancer can be arranged in order to early detection of colonic tumors and then removed,to the secondary prevention of colorectal malignancy or early diagnosis of colorectal cancer early treatment。
目錄
摘要.....................................................I Abstract................................................II
致謝................................................... VI
目錄.....................................................V 第一章 前言...............................................1
第二章 文獻探討...........................................2
第一節 大腸直腸癌的常見好發部位.........................2
第二節 大腸直腸癌的致癌機轉............................2
2-1 腺瘤-腺癌順序(adenoma-carcinoma sequence)..2
2-2 新合成路徑(de novo pathway).................3
2-3 鋸齒狀息肉路徑(serrated polyp pathway).......3
第三節 大腸息肉病理型態的分類...........................4
3-1 腺瘤性息肉....................................4
3-2 錯構瘤息肉....................................5
3-3 增生性息肉....................................5
3-4 發炎性息肉....................................5
第四節 影響大腸息肉發生的可能因子.......................5
4-1 生理特徵與大腸息肉之相關性.....................5
4-2 慢性疾病與大腸息肉之相關性.....................7
4-3 抽煙、喝酒、檳榔與大腸息肉之相關性..............8
4-4 飲食習慣與大腸息肉之相關性.....................8
第三章 研究動機與目的.....................................10
第四章 研究方法..........................................11
第一節 個案收集......................................11
第二節 問卷內容......................................11
第三節 分析方法......................................12
第五章 研究結果..........................................13
5-1 生理特徵與大腸息肉之相關性........................13
5-2 慢性疾病與大腸息肉之相關性........................14
5-3 抽煙、喝酒、檳榔與大腸息肉之相關性.................14
5-4 飲食習慣與大腸息肉之相關性........................15
第六章 討論..............................................16
參考文獻.................................................18
圖表目錄
圖 1研究收案流程.........................................21
表 1性別百分比例.........................................22
表 2基本資料特性分析......................................23
表 3年齡分組分析.........................................24
表 4身體質量指數分析......................................25
表 5腰臀圍比分析.........................................26
表 6個案腸胃相關疾病分析..................................27
表 7個案過敏相關病史分析..................................28
表 8個案肝病史分析.......................................29
表 9個案慢性病史分析......................................30
表 10個案抽煙習慣分析.....................................31
表 11-1個案喝酒習慣分析之一..............................32
表 11-2個案喝酒習慣分析之二..............................33
表 12個案吃檳榔習慣分析...................................34
表 13個案喝酒習慣分析.....................................35
表 14個案喝咖啡習慣分析...................................36
表 15個案喝含糖飲料習慣分析...............................37
表 16個案食物攝取習慣分析-豬肉..... ......................38
表 17個案食物攝取習慣分析-內臟類食物......................39
表 18個案食物攝取習慣分析-燒烤類食物......................40
表 19個案食物攝取習慣分析-水果............................41
表 20個案食物攝取習慣分析-蔬菜............................42
表 21素食習慣分析........................................43
表 22個案用藥習慣分析.....................................44
附錄
附錄 一、大腸直腸部位及罹癌機率............................45
附錄 二、正常細胞進展為大腸癌的途徑........................46
附錄 三、正常大腸粘膜演變成大腸癌的進展過程.................47
附錄 四、大腸鏡檢查評估問卷資料............................48
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