慢性腹泻诊断方法的临床分析  

Clinical analysis of the diagnostic methods of chronic diarrhea

作　　者：贾勇[1] 王巧民[1] 郑邦海[1] 吴正祥[1] 

机构地区：[1]安徽省立医院消化内科,合肥230001

出　　处：《临床中老年保健》2003年第1期40-42,共3页

摘　　要：目的　探讨慢性腹泻诊断的最经济有效的检查手段。方法　收集近 6年来全结肠镜检查 5 0 14例 ,分成三组 ,结合病史 ,分析其病因及病变分布范围。结果　慢性腹泻组的患者 1987例中 5 7 3%为正常肠粘膜相 ,4 2 7%有内镜下异常 ,其前三位病因是非特异性炎症 (73 9% )、肠息肉 (13 3% )及溃疡性结肠炎(11 1% ) ,而结直肠癌仅占 0 9% (在慢性腹泻中的检出率仅为 0 4 % )。异常者病变范围为横结肠以远病变占 72 2 % (6 2 1/ 84 8) ,全结肠一致性病变占 2 5 4 % (2 15 / 84 8) ,右半结肠仅占 1 4 % (12 / 84 8) (无一例癌症 ) ,加上正常粘膜相的病例 ,左半结肠镜检查的诊断率可达 99 4 %。Objective The aim of this study is to look for the optimal,economical diagnostic methods of chronic diarrhea.Methods Data of 5014 patients undergoing pan colonoscopy during past 6 years were collected.They were divided into three groups for analysing their causes and anatomic distribution of the lesions combining the patients' history.Results 57.3% was normal bowel mucosa and 42.7% abnormality in the patients with chronic diarrhea.Precedent three causes in abnormality were non typical inflammation(73.9%),polyps(13.3%) and ulcerative colitis(11.1%).The colon cancer only accounted for 0.9%(its detective rate in chronic diarrhea was 0.4%).Anatomic distribution of the colonic lesions in chronic diarrhea:The 73.2%(621/848 cases) lesions were in the distal colon(i.e.,the area of the colon within reach of a 60cm sigmoidoscope of `left colonoscopy',including transverse colon,descending colon,sigmoid colon and rectum).The 25.3% lesions were in throughout the colon.The lesions in the `right colon' were only 1.4%(12/848 cases),and no cancer in this area.The correct diagnostic rate using `left colonoscopy' can reach 99.4%.Conclusion Diagnostic method for chronic non bloody diarrhea using `left colonoscopy' is highly efficient and cost effective.

关 键 词：诊断 临床分析 慢性腹泻 结肠镜 

分 类 号：R574.62[医药卫生—消化系统]