性传播感染引起的直肠炎6例临床分析  

Clinical analysis of 6 cases of proctitis caused by sexually transmitted infections

作　　者：李新建 闫会文[2] 王杨 韩旭 熊芳[1] 韦兰 刘连成[1] LI Xinjian;YAN Huiwen;WANG Yang;HAN Xu;XIONG Fang;WEI Lan;LIU Liancheng(Beijing Anorectal Hospital(Beijing Erlonglu Hospital),Beijing 100120,China;Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]北京市肛肠医院(北京市二龙路医院),北京100120 [2]首都医科大学附属北京地坛医院,北京100015

出　　处：《皮肤性病诊疗学杂志》2025年第3期185-189,共5页Journal of Diagnosis and Therapy on Dermato-venereology

摘　　要：目的分析性传播感染引起的直肠炎的临床表现、疾病特征及诊疗过程,为临床工作提供参考。方法收集2023年1—11月北京市肛肠医院肛肠急诊科接诊的以肛门疼痛为首发症状患者的临床资料,进行汇总分析。结果6例患者均为青年男性,均为男男性行为者,其中2例确诊HIV感染。发病前1~2周均有肛交史。6例患者均以肛门疼痛为首发症状,查体可见肛管肿胀,指诊可见脓性分泌物,5例出现低热,2例发现直肠溃疡。3例沙眼衣原体核酸检测阳性,2例淋球菌核酸检测阳性,1例沙眼衣原体、淋球菌核酸检测均阳性。3例直肠彩超可见异常低回声。治疗上给予头孢曲松肌肉注射或莫西沙星静脉滴注,同时给予医院自制剂外用治疗2周均痊愈。结论性传播感染引起的直肠炎临床较为少见,且无典型特征。临床医生需注意详细追问病史,避免误诊、误治。Objective To analyze the clinical manifestations,characteristics,and the diagnosis and treatment of proctitis caused by sexually transmitted infections.Methods Clinical data from patients with anal pain as the primary symptom were collected and analyzed at the anorectal emergency department of Beijing Anorectal Hospital between January 2023 and November 2023.Results All six patients were young men who had sex with men,and two were diagnosed with HIV infection.All patients had a history of anal intercourse 1-2 weeks before the onset of the disease.All patients presented with anal pain as the primary symptom.Physical examination revealed swelling of the anal canal.Digital rectal examination revealed purulent secretions.Five cases experienced low fever,and 2 cases had rectal ulcers.Three cases were positive for Chlamydia trachomatis,2 cases were positive for Neisseria gonorrhoeae,and 1 case was positive for both Chlamydia trachomatis and Neisseria gonorrhoeae.Three cases showed abnormal hypoechogenicity on rectal ultrasound.In terms of the treatment,intramuscular injection of ceftriaxone or intravenous infusion of moxifloxacin,and a homemade topical ointment were given.All patients recovered after 2-week treatment.Conclusions Proctitis caused by sexually transmitted infections is relatively rare in clinical practice,and it has no typical characteristics.Clinicians should pay attention to a detailed medical history and avoid misdiagnosis and mistreatment.

关 键 词：沙眼衣原体 淋球菌 直肠炎 男性 男男性行为者 

分 类 号：R574.62[医药卫生—消化系统]