130例缺血性肠炎患者的临床及内镜特点分析  

Analysis of Clinical and Endoscopic Characteristics of 130 Patients with Ischemic Enteritis

作　　者：李晓宁[1] LI Xiao-ning(The Third People's Hospital of Dalian,Dalian 116031,China)

机构地区：[1]辽宁省大连市第三人民医院,辽宁大连116031

出　　处：《中国医药指南》2020年第20期139-140,共2页Guide of China Medicine

摘　　要：目的分析缺血性肠炎患者的临床及内镜特点。方法回顾性分析2015年~2019年大连市第三人民医院收治的130例缺血性肠炎患者的临床资料,分析一般资料,病因、临床表现、内镜特点及病理结果。结果共纳入130例患者,其中男性72例(55%),女性患者58例(45%),平均年龄(63.5±4.1)岁。腹痛118例(90.7%),便血106例(81.5%),腹胀30例(23.1%),恶心26例(20%),呕吐15例(11.5%),腹泻43例(33.1%),便秘18例(13.8%),发热45例(34.6%)。结肠镜下主要表现为黏膜明显充血、水肿、糜烂、出血、溃疡。结肠受累情况:左半结肠为最常见受累部位,共99例,其中直肠受累8例;右半结肠受累者24例;结肠广泛受累者7例;合并结肠息肉42例。病理表现:组织黏膜水肿、淋巴细胞和中性粒细胞浸润,黏膜固有层出血,部分可见小血管内纤维素样血栓形成。结论缺血性肠炎好发于存在动脉硬化基础疾病的中老年人,常表现为急性腹痛、血便,左半结肠最易受累。需重视内镜及病理检查,以防误诊,一旦确诊,应积极治疗。Objective To analyze the clinical and endoscopic characteristics of patients with ischemic colitis.Methods We retrospectively analyzed the demographic data,clinical manifestation,colonoscopy characteristics of the ischemic colitis patients with who received initial treatment in the third people’s hospital of Dalian from 2015 to 2019.Results Totaled 130 cases of patients enrolled.Among them,55%(72/130)were males,45%(58/130)were females,the mean age was(61.5±4.1)years.The clinical predominant symptoms were abdominal pain 90.7%(118/130),hematochezia 81.5%(106/130),abdominal distension 23.1%(30/130),nausea 20%(26/130),vomiting 11.5%(15/130),diarrhea 33.1%(43/130),constipation 13.8%(18/130),fever34.6%(45/130).The colono scopy identified hyperemia,edema,hemorrhage,ero sion and ulcer in the colon.Ninety-nine patients had left colonic involvement,8 of them had rectal involvement;twenty-four patients had right colonic involvement;seven patients had the whole colonic involvement;24 of them with colonic polyps.The major manifestations in pathological were mucosal edema,lymphocytes and neutrophils infiltrate,mucosal lamina propria hemorrhage,fibrinoid thrombosis in small vessels.Conclusion Ischemic colitis mostly in the male and the elderly.It was often manifested as acute abdominal pain and hematochezia,The left colon is one of the most involved areas.Attention should be paid to colonoscopy and pathological examination.To prevent misdiagno sis,once diagno sed should be actively treated.

关 键 词：结肠炎 缺血性 诊断 结肠镜检查 

分 类 号：R574.62[医药卫生—消化系统]