中青年缺血性肠炎93例临床特点分析  

Analysis of Clinical Characteristics for 93 Young and Middle-aged Patients with Ischemic Colitis

作　　者：尹小菲 康文全[1] YIN Xiao-fei;KANG Wen-quan(Department of Gastroenterology,Shenzhen Nanshan People's Hospital and Affiliated Shenzhen Sixth Hospital of Guangdong Medical University,Shenzhen(518052),China)

机构地区：[1]深圳市南山区人民医院(广东医科大学深圳第六医院)消化内科,深圳518052

出　　处：《中国中西医结合外科杂志》2018年第4期385-389,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：广东省深圳市卫生计生系统科研项目(201403132)

摘　　要：目的:探讨中青年(年龄26~60岁)缺血性结肠炎患者的临床特点。方法:对2013年10月—2017年10月在深圳市南山区人民医院确诊为缺血性肠炎的中青年住院患者的临床资料进行回顾性分析,并与同期收治的老年组(年龄≥60岁)患者相比较,观察两组患者的危险因素、临床表现、预后、实验室检查指标、病变部位及内镜特征、影像学检查(腹部电子计算机断层成像及血管成像:腹部CT及CTA)是否存在差异。结果:中青年组患者的主要危险因素为腹部手术史、高血压病及高脂血症;主要临床表现为腹痛和便血;C-反应蛋白和D-二聚体水平升高。血小板、纤维蛋白原水平低于老年组(P<0.05),中青年组患者的病变范围小于老年组,多累及单一结肠段。96%(45/47)患者经中西医结合保守治疗后治愈和缓解。2例经外科手术治疗缓解。结论:中青年缺血性肠炎患者的病变范围小于老年患者,血小板、纤维蛋白原水平低于老年患者,而其它实验室检查指标、临床表现、预后及影像学表现与老年患者无明显差异。中青年缺血性肠炎患者的预后较良好。Objective To investigate the clinical characteristics of young and middle-aged patients(26 to 60 years old)with ischemic colitis.Methods The clinical data of young and middle-aged hospitalized patients diagnosed with ischemic colitis from October 2013 to October 2017 in Shenzhen Nanshan People's Hospital were analyzed retrospectively,and compared to elderly patients(aged≥60 years)treated with the same period.The differences between two groups in risk factors,clinical manifestation,prognosis,laboratory examination parameters,endoscopic features and imaging examination(abdomen computed tomography and angiography:abdominal CT and CTA)were observed.Results In the young and middle-aged group,the main risk factors were past history of abdominal surgery,hypertension and hyperlipidemia,and the prominent clinical manifestations were abdominal pain and hematochezia.Patients had increased levels of D-dimer and C-reactive protein(CRP).The levels of platelet(PLT)and fibrinogen(Fib)were lower than those in the elderly group(P<0.05),and the lesions in the young and middle-aged group were mainly involved in single colon,which were smaller than those of elderly group.Symptoms relieved by conservative treatment(combination of traditional Chinese and Western medicine such as fasting,anti-infection and improvement of circulation)in 96%(45/47)of the patients.Two patients were relieved by surgical treatment.Conclusions The lesions in the young and middleaged group were smaller than those in the elderly group.The levels of platelet and fibrinogen in the young and middle-aged group were lower than those in the elderly group,but there was no significant difference among other laboratory examination parameters,clinical manifestations,progonosis and imaging examination.The prognosis of young and middle-aged patients with ischemic colitis was satisfactory.

关 键 词：缺血性肠炎 中青年 临床特点 

分 类 号：R656.7[医药卫生—外科学]