缺血性结肠炎的内镜检测和临床特点分析  

ENDOSCOPIC FINDINGS AND CLINICAL FEATURES OF ISCHEMIC COLITIS

作　　者：贾柳萍 詹俊[2] 王海霞 黄鹤 古雨平 谢春生 

机构地区：[1]佛山市南海人民医院,佛山528200 [2]中山大学第二附属医院,510120

出　　处：《现代预防医学》2005年第5期575-576,共2页Modern Preventive Medicine

摘　　要：目的:观察缺血性结肠炎的临床特点,内镜和病理特征。方法:对6 4例缺血性结肠炎病人的临床经过、结肠镜、病理及CT表现进行总结。结果:本病多发生于5 0岁以上中老年人(87 .5 %) ,而且多伴有(92. 2 %)一定的基础疾病,包括心脑血管疾病、糖尿病和自身免疫性疾病以及腹部手术、便秘史等,临床表现为腹痛,便血,腹泻;72h内行结肠镜检查发现病变多位于左半结肠(6 8.8%) ,结肠镜表现为病变肠管黏膜与正常肠管界限清晰,病变黏膜充血水肿出血糜烂和溃疡,可分为坏疽和非坏疽型,非坏疽型大多在2周后恢复,如能早期诊断与治疗,多数预后良好;坏疽型需要及时手术治疗。结论:中老年病人出现急性腹痛、便血时,及时结肠镜检查和病理活检对明确缺血性结肠炎诊断,了解病变范围和分型,判断预后非常有用。Objective:To overview the clinical and pathological features,endoscopic fingding of ischemic colitis.Methods:Retrospective analysis was conducted.Results:Of the 64 cases,875% were over 50 years old.922% of the cases were associated with the basal diseases such as cardio-cerebrovascular disorder,diabetes or auto-immunologic disease as well as the history of abdominal operation or constipation.Sudden abdominal pain and bloody diarrhea were the chief complaints.Colonoscopy were finished in 72 hours.Endoscopic lesions located mainly in left colon with segmental distribution,demarcated with normal areas.The affected bowel showed mucosal edema,erosion,ulceration.IC were divided to nongangrenous and gangrenous.Most lesions of nongangrenous recover in 14 days as early diagnosis and early treatment.Gangrenous colitis is only indication for surgery.Conclusion:IC should be suspected in all eldly patients with acute onset of abdominal pain and bloody diarrhea.Early colonoscopy is of diagnostic significance.

关 键 词：缺血性结肠炎 临床特点分析 内镜检测 自身免疫性疾病 结肠镜检查 心脑血管疾病 50岁以上 诊断与治疗 中老年病人 坏疽型 病理特征 临床经过 CT表现 中老年人 基础疾病 腹部手术 临床表现 左半结肠 黏膜充血 手术治疗 急性腹痛 

分 类 号：R574.62[医药卫生—消化系统] R743.34[医药卫生—内科学]