缺血性肠病26例临床诊治分析  

Clinical Analysis of 26 Patients with Ischemic Bowel Disease

作　　者：郭昌贵 于慧敏[2] 

机构地区：[1]镇雄县人民医院内科,云南镇雄657200 [2]昆明医学院第一附属医院超声科,云南昆明650031

出　　处：《昆明医学院学报》2012年第3期53-56,共4页Journal of Kunming Medical College

基　　金：国家自然科学基金地区基金资助项目(30860269)

摘　　要：目的探讨缺血性肠病的临床特征及诊断方法,进一步提高对该病的认识.方法回顾性分析镇雄县人民医院住院治疗的26例缺血性肠病患者的临床资料.结果 26例患者中男16例,女10例,均有其他合并性疾病,其中伴发高血压、冠心病10例,糖尿病史7例,心瓣膜病5例,同时伴心房颤动2例、脑梗死1例、肝硬化1例.主要临床表现为腹痛、血便;24例行全结肠镜检查,确诊19例(79.2%);6例行CTA,确诊4例(66.7%);肠系膜动脉造影(DSA)12例,确诊7例(58.3%);16例行CT检查,确诊7例(43.8%);26例行彩色多普勒超声检查,确诊8例(30.8%).内科保守治疗24例有效,2例无效转外科手术治疗好转.结论缺血性肠病绝大多数患者临床伴有其他基础疾病,由于临床症状和体征无特异性,误诊率和死亡率高.如及时行肠镜等辅助检查能早期发现及早期治疗,多数患者预后良好.Objective To explore the clinical features and diagnosis methods of ischemic bowel disease,and to further strengthen the knowledge of this disease.Method Clinical data of 26 cases with ischemic bowel disease for five years in our hospital were retrospectively analyzed.Results Among 26 cases,16 cases were male and 10 cases were female.All these patients were accompanied with other disease,including 10 cases with high blood pressure and coronary heart disease,7 cases with diabetes history,5 cases with heart valve disease,and 2 cases with atrial fibrillation at the same time,1 case with cerebral infarction and 1 case with liver cirrhosis.Cinical manifestations were abdominal pain and bloody stool;24 cases had done the whole colonoscopy,and 19 cases were diagnosed(79.2%).6 underwent CTA and 4 cases were diagnosed(66.7%).The mesenteric artery angiography(DSA)was given in 12 cases,7 patients were diagnosed(58.3%);16 cases were given routine CT examination,and 7 patients were diagnosed(43.8%).26 cases were given color doppler ultrasound examination,and 8 cases were diagnosed(30.8%).Symptoms were relieved by conservative treatment in 24 patients,2 patients were cured by operation.Conclusions Most of ischemic bowel disease are accompanied with other baseline diseases.Its clinical symptoms and signs are not specific,so the misdiagnosis rate and mortality are high.If conducting the auxiliary check,such as colonoscopy and so on,most cases can be early diagnosed and cured.

关 键 词：肠疾病 局部缺血 分析 

分 类 号：R57[医药卫生—消化系统]