摘要
目的：评价克罗恩病的诊疗现状，总结其临床、病理特点及治疗转归。方法：回顾性分析220例炎症性肠病住院患者中48例克罗恩病的病历资料，详细记录临床表现、实验室检查、X线和内镜、病理及治疗情况。结果：1987年至1995年共诊断克罗思病4例，1995年后诊断44例。克罗恩病高峰发病年龄为17～40岁，占75．0％（36／48）；30岁以下发病者占43．8％（21／48）。临床主要表现为腹痛、腹泻和便血；伴肠道外表现16例（33．3％），伴有肛周疾病3例（6．3％），肠瘘2例（4．2％）。内镜诊断符合率85．7％（36／42），表现为节段性病变，溃疡形成、肠管狭窄和卵石征。X线诊断符合率为84．2％（32／38），主要表现为龛影、肠管狭窄及卵石征。病理非干酪性上皮样肉芽肿总检出率为43．2％（19／44）。90％（27／30）经药物治疗症状改善，有13例行手术治疗。结论：近10年来克罗恩病诊断例数明显增加。内镜＋病理＋X线造影检查是诊断克罗恩病的主要手段。小肠镜、胶囊内镜及多次病王毋枪杏晡访右鼬千楗高诊断蜜．
Objective： To evaluate the contemporary diagnostic and therapeutic status for Crohn＇s disease （CD）, and analyze its clinical and pathologic manifestation. Methods： Retrospectively we reviewed 220 hospitalized inflammatory bowel disease （IBD） cases in which 48 were diagnosed as CD. Data of diagnostic and therapeutic details were recorded. Results： In the past 10 years 44 of the 48 CD cases were diagnosed in recent and 75.0% of the cases were in the onset age range from 17 to 40 years. The most common symptoms were abdominal pain, diarrhea and bloody stool. 16 （33.3%） of the cases were accompanied with extra-intestinal manifestations, 3 （6.3 % ） with perianal abscess, and 2 （4.2%） with intestinal fistulation. The main findings through colonoscopy were ulceration, obstruction and cobble stone sign, with a diagnostic correspondence of 85.7% （36/42）. Non-caseous granulomas were totally identified in 43.2% （19/44） of the histology. Thirty cases were administrated with Sulfasalazine/Mesalazine （SASP/5-ASA） or corticosteroids/immuno-suppressor in which 27 got clinically improved. Thirteen patients underwent surgery. Conclusion： The diagnostic incidence of Crohn＇s disease has been increased in recent years. The combination of endoscopy, radiography and histology is the best way for the diagnosis of CD. Small intestinal endoscopy and capsule endoscopy with repeated histopathology and follow-up are helpful for the diagnosis.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2006年第4期407-410,共4页
Journal of Peking University:Health Sciences
关键词
CROHN病
诊断
鉴别
病理学
Crohn disease
Diagnosis, differential
Pathology
