摘要
目的探讨缺血性结肠炎的临床特征、内镜下表现及治疗方法,提高对本病的认识,降低病死率。方法回顾性分析东北地区2家医院收治的30例缺血性结肠炎病例临床资料,其中男性13例,女性17例。结果30例患者中,平均年龄59.9岁,50岁以上多见(73.3%)。急性25例,亚急性2例,慢性3例。临床表现以腹痛(93.3%),便血(83.3%),腹泻(43.3%)最多见。外周血白细胞计数73.3%超过正常,腹部B超检查80%提示肠管病变,腹部CT提示肠道病变。行结肠镜检查26例,病变部位多见于乙状结肠(55.6%)和降结肠(51.9%),镜下表现为黏膜充血、水肿(96.3%),糜烂(88.9%),与周围黏膜分界清晰(81.5%),多发溃疡(40.7%),有血迹(29.6%),肠管狭窄(25.9%)等。27例行内科治疗(止血,改善肠道血液供应,抗凝,抗生素,营养支持等),3例行手术治疗,治愈率为23.3%(7/30),缓解率为66.7%(20/30),无死亡患者。结论缺血性结肠炎多见于老年人,症状不典型,及时行结肠镜检查和影像学检查是提高诊断率的有效方法。对本病认识的提高,早期行抗凝,改善血液循环或手术治疗,可提高总体疗效,降低病死率。
Objective To analyze clinical and endoscope features of ischemic colitis （IC）. To recognize this disease and decrease fatality rate. Methods Thirty patients with ischemic colitis were retrospectively analyzed in two northeast hospitals. Results Mean age was 59.5 years old. Most patients of cases were more than fifty year-old（73.3% ）. Twenty-five patients were acute cases,2 patients were subacute and 3 patients were chronic cases. Clinical features of ischemic colitis were abdominal pain（93.3% ）, hemafacia（83.3% ） and diarrhea（43.3% ）. Peripheral white blood cells count exceeded in most of these patients（73.3% ）. B-ultrasonography showed intestinal canal of 80% cases were abnormal. Twenty-six patients accepted eoloscopy. The eoloseope features were mucous hyperemia （96.3%） , erosion （ 88.9 % ）, ulcers （40.7 % ）, blood stain （ 29.6 % ） and stenochoria （ 25.9 % ）. Twenty-seven patients accepted treatment of internal medicine,3 patients accepted surgical intervention. Cure rate was 23.3% and remission rate was 66.7%. No patient died. Conclusion Ischemic colitis mostly occurs in aged people. The clinical manifestation of ischemic colitis is unspeeificly. Taking coloscopy and imageology in time are effective methods for diagnosis. Taking anticoagulation, amelioration of blood circulation and operation could increase healing effect and decrease fatality rate.
出处
《哈尔滨医科大学学报》
CAS
北大核心
2009年第5期493-496,499,共5页
Journal of Harbin Medical University
关键词
缺血性结肠炎
老年人
结肠镜
诊断
治疗
ischemic colitis
aged people
coloscopy
diagnosis
therapy
