溃疡性结肠炎的内镜特点和临床分析  

Endoscopic features and clinical analysis on ulcerative colitis

作　　者：项平[1] 保志军[1] 徐富星[1] 欧平安[1] 

机构地区：[1]上海市华东医院内镜室,200040

出　　处：《中华消化杂志》2003年第4期217-219,共3页Chinese Journal of Digestion

摘　　要：目的　总结溃疡性结肠炎 (UC)的临床特点及内镜下表现。方法　收集 1975年至 2 0 0 1年经结肠镜检查及病理确诊的UC患者的相关资料 ,其中 1975～ 1994年组有 4 86例 ,1995～ 2 0 0 1年组4 90例 ,观察其临床特点及内镜表现。确诊靠病理活检。结果　在 1975～ 1994年和 1995～ 2 0 0 1年两组中 ,经结肠镜检查确诊的UC患者占同期结肠镜的总数从 3.5 1%上升至 4 .4 4 % ,男女之比分别为 1.6 7和 1.2 5 ,平均发病年龄从 4 2 .4岁上升至 5 1.5岁 ,高峰年龄段分别是 30～ 4 9岁和 4 0～ 4 9,≥ 6 0岁。临床主要表现为黏液脓血便、腹泻、腹痛等 ,病变范围 :直肠及乙状结肠炎占 5 5 .4 %和 6 4 .5 % ,左半结肠炎占 17.3%和 13.9% ,全结肠炎占 11.9%和 14 .3%。分别有 89.9%和 90 .4 %的患者病程小于 10年。结论　UC的发病例数有所增加 ,病变主要以左半结肠为主 ,病程短 ,发病年龄相对较大 ,癌症发生率及并发症低。结肠镜及活检是诊断UC的主要方法。Objective To evaluate the clinical and endoscopic features of ulcerative colitis(UC). Methods The cases of UC were collected from 1975 to 2001. According to the diagnostic criteria of Chengdu conference, 486 and 490 patients were diagnosed as UC in our hospital from 1975 to 1994 and from 1995 to 2001 respectively. Their records were retrieved and the data were analyzed for sex, age, presentation, the course of the illness and lesion range. Results In the two groups from 1975 to 1994 and from 1995 to 2001, the proportion of patients diagnosed as UC under colonoscopy was increased from 3.51% to 4.44%. The ratio of male to female was 1.67 and 1.25 respectively. The mean age at the diagnosis increased from 42.4 years old to 51.5 years old, and the peak age was between 30 and 49 years old, between 40 and 49 years old and greater than 60 years old respectively. The typical clinical manifestations of UC were bloody mucopurulent stool, diarrhea and abdominal pain. Proctosigmoiditis or proctitis was found in 269 patients (55.4%) and 316(64.5%), left side colitis in 84(17.3%) and 68(13.9%), pancoltitis in 58( 11.9% ) and 70(14.3%) respectively. In the two groups, there were 437( 89.9% ) and 443(90.4%) patients who had the course of less than 10 years respectively. The definitive diagnosis of UC was dependent on biopsy. Conclusions The lesions of UC are commonly located in the left side colon, the course of UC is short, the age of onset is relatively high in the middle and old aged group, and the prevalence of both malignancy and complications is low. Colonoscopy with biopsy is considered to be the major means for the diagnosis of UC.

关 键 词：溃疡性结肠炎 临床特点 结肠镜检查 病理检查 病程 发病年龄 

分 类 号：R574.62[医药卫生—消化系统]