缺血性肠病15例临床分析  

The analysis of 15 cases of ischemic bowel disease.

作　　者：朱健焕[1] 杨蒲芳[1] 陈范嵘[1] 蒋舒平[2] 

机构地区：[1]上海市普陀区人民医院消化内科,上海200060 [2]上海市普陀区人民医院病理科,上海200060

出　　处：《华中医学杂志》2009年第1期28-29,37,共3页Central China Medical Journal

摘　　要：目的探讨缺血性肠病的临床诊断及治疗方法。方法对15例缺血性肠病的临床资料、肠镜所见以及病理改变进行回顾性分析。结果15例患者中,男4例,女11例,其中高血压史5例,糖尿病史3例,脑梗塞史4例,冠心病及心律失常病史7例,外伤史1例。该病的病理改变以肠壁充血、水肿、出血及变性坏死为主,伴不同程度的炎症反应。结论缺血性肠病的临床症状与体征无特异性,误诊率较高。对于具有高血压、动脉硬化、冠心病合并心律失常及血栓形成等基础疾病的老年患者,急性发作腹痛、便血应高度考虑本病,及早查肠镜以明确诊断。而早期诊断后早期行抗凝、改善微循环等内科保守治疗,多数病例可治愈。Objective To analyze clinical features and sum up experience of ischemic bowel disease. Methods Clinical data, endoscopic examination and pathological changes of 15 patients with ischemic bowel disease were retrospectively analyzed. Results 4 patients were male and 11 were female. 5 patients were accompanied with hypertension, 3 with diabetes, 4 had a history of Cerebral infarction, 7 had a history of coronary disease and arrhythmia, 1 had a history of traumatism. The main pathological features of ischemic bowel disease are hyperemia, edema, hemorrhage, degeneration and necrosis of bowel wall with various degrees of inflammatory reaction. Conclusion Ischemic bowel disease has certain clinical pathological features, but its clinical manifestation is less specific. The rate of misdiagnosis and mortality are high. Elder patients with acute abdominal pain and hematochezia,especially with a history of hypertension, atherosclerosis, coronary disease, arrhythmia, and cerebrovascular disease should be considered for the possibility of ischemic bowel disease, which an earlier endoscopic examination is expected. With an earlier medical conservative threatment of anticoagulent, improving microcirculation, most cases could be healed.

关 键 词：缺血性肠病 诊断 内窥镜 病理 

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