回盲部溃疡性病变的临床特征及鉴别诊断分析  

Clinical features and differential diagnosis of ileocecal ulcer disease

作　　者：周琳[1] 刘源[1] 史成章[1] 张连峰[1] Zhou Lin;Liu Yuan;Shi Chengzhang;Zhang Lianfeng(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内科,450052

出　　处：《中国实用医刊》2020年第13期13-15,共3页Chinese Journal of Practical Medicine

基　　金：河南省卫生科技创新型人才工程资助项目(4107)。

摘　　要：目的分析375例回盲部溃疡性病变的临床特征、内镜特点及鉴别诊断。方法抽取2016年1月至2018年12月在郑州大学第一附属医院行结肠镜检查发现有回盲部溃疡性病变的375例患者为研究对象,回顾性分析其临床资料,总结其临床特征、结肠镜表现、病理特征及鉴别诊断。结果回盲部肿瘤、回盲部非特异性炎性溃疡、溃疡性结肠炎、阑尾炎多可通过内镜表现及病理诊断确诊;白塞氏病、克罗恩病及肠结核多依赖反复内镜检查、病理活检、试验性治疗及随访。结论回盲部溃疡病变的病因诊断相对困难,部分需长期内镜随访,并结合病理活检及试验性治疗。寻求特异性及敏感性更高的标记物非常必要。Objective To analyze the clinical symptoms, endoscopic characteristics and differential diagnosis of 375 patients with ileocecal ulceration.Methods A total of 375 patients with ileocecal ulceration diagnosed by colonoscopy in the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2018 were selected. Their clinical data were retrospectively analyzed to summarize the clinical features, colonoscopic manifestations, pathological characteristics and differential diagnosis of the disease.Results Ileocecal tumor, ileocecal simple ulcer, ulcerative colitis and appendicitis usually could be confirmed by endoscopic manifestations and pathological diagnosis. While diagnosis of Behcet disease, Crohn disease and intestinal tuberculosis depended on repeated endoscopy and pathological biopsy, experimental treatment and follow-up.Conclusions The diagnosis of ileocecal ulcer is relatively difficult and requires long-term endoscopic follow-up, combined with pathological biopsy and experimental treatment. It’s necessary to search diagnostic markers with higher specificity and sensitivity for ileocecal ulcer.

关 键 词：回盲部溃疡 溃疡性结肠炎 肠结核 克罗恩病 

分 类 号：R574[医药卫生—消化系统]