缺血性肠炎的临床表现及内镜特点分析  

Analysis of clinical manifestations and endoscopic characteristics of ischemic enteritis

作　　者：陈柯豫 黄艳齐 张玲利 CHEN Keyu;HUANG Yanqi;ZHANG Lingi(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450052

出　　处：《中国现代医生》2023年第19期1-3,23,共4页China Modern Doctor

基　　金：国家自然科学基金项目(81802859)。

摘　　要：目的分析缺血性肠炎的临床表现及内镜特点。方法收集2015年1月至2022年12月于郑州大学第一附属医院确诊的109例缺血性肠炎患者的临床资料,分析其临床表现、危险因素、实验室检查、内镜及影像学检查特征。结果共纳入109例患者,男43例,女66例,平均年龄(62.2±12.3)岁;临床表现以腹痛、腹泻、便血为主。结肠镜下病变常呈节段性分布,主要表现为黏膜充血、水肿、糜烂、溃疡,部分可见溃疡处覆有脓苔、黏膜下血管网消失;病理表现为黏膜慢性炎症或黏膜慢性活动性炎症伴糜烂。左半结肠为最常见的受累部位,共88例;其次为全结肠(14例)、右半结肠(9例)、直肠(9例),合并肠息肉27例。实验室检查见白细胞(43例)、C反应蛋白(61例)、D-二聚体(64例)升高。结论缺血性肠炎好发于有基础疾病的中老年人群,常以腹痛、腹泻、便血为主要临床表现,最易累及左半结肠,内镜下可见黏膜充血、水肿、糜烂、溃疡,且实验室指标常有改变。Objective To analyze clinical manifestations and endoscopic characteristics of ischemic enteritis.Methods The clinical data of 109 patients with ischemic enteritis diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022 were collected,and their clinical manifestations,risk factors,laboratory examination,endoscopic characteristics and imaging examination characteristics were analyzed.Results A total of 109 patients were included,including 43 males and 66 females,with a mean age of(62.2±12.3)years.The clinical manifestations were mainly abdominal pain,diarrhea,and hematochezia.Under colonoscopy,the lesions often presented segmental distribution,and the main manifestations were mucosal congestion,edema,erosion,and ulcers.Some ulcers were covered with pus coating and the submucosal vascular network disappeared.The major manifestations in pathological were chronic or chronic active inflammation of the mucous membranes with erosions.The left colon was the most common site of involvement,with a total of 88 cases,followed by the whole colon(14 cases),the right colon(9 cases),rectum(9 cases),and intestinal polyps in 27 cases.Laboratory tests showed elevated white blood cells(43 cases),C-reactive protein(61 cases),and D-dimer(64 cases).Conclusion Ischemic enteritis tends to occur in middle-aged and elderly people with underlying diseases,often with abdominal pain,diarrhea,hematochezia as the main clinical manifestations,the most likely to involve the left colon.Mucosal edema,erosion and ulcer can be seen under endoscope,and laboratory indexes often change.

关 键 词：缺血性肠炎 临床特点 内镜特点 

分 类 号：R516.1[医药卫生—内科学]