摘要
背景:缺血性结肠炎(IC)在周外报道较多,周内报道较少,近年来有增多的趋势,但对IC临床特点的认识尚有限。目的:总结IC的临床特点和诊断方法,提高对该病的认识和治疗水平。方法:同顾性分析2002年9月～2007年2月期间浙江中医药大学附属第一医院消化内科确诊为IC患者的临床资料,详细记录每位患者的病史、临床症状、结肠镜下表现、病理检查、诊治经过和转归,并进行总结。结果:IC患者共36例,男女之比为1:3.5,50岁以上患者占91.7%,且多数(91.7%)伴有相关的基础疾病;临床上多以腹痛(75.0%)、血便(91.7%)为首发表现,其中鲜血便占57.6%;腹部体征有压痛者占55.6%,其中80%与病变部位相关。36例均行电子结肠镜检查,病变部位多位于乙状结肠(63.9%)和降结肠(52.8%)。均予扩血管和内科综合治疗,22例痊愈、14例好转,平均痊愈或好转时间为12d。结论:IC好发于老年女性,多急性发作,其典型表现为急性腹痛和便血,辅助检查可首选结肠镜,早期诊断为治疗的关键,及时扩血管治疗大多预后良好,病程较短,恢复较快。
Background：Ischemic colitis （IC） is rarely reported in China than abroad. Although there is a tendency to be increasingly reported nowadays, yet the recognition of its clinical features is still limited. Ahns： To analyze the clinical features and diagnostic methods of patients with IC for improving the recognition and the efficacy of therapeutic treatment. Methods： Retrospective analysis of the clinical data of 36 cases of IC admitted from September 2002 to February 2007 in the Department of Gastroenterology of the First Affiliated Hospital of Zhejiang Chinese Medical University was carried out, including the medical history, clinical symptomatology, colonoscopic appearance, histopathology, treatment and prognosis. Results： Among these patients, the male-female ratio was 1：3.5, 91.7% of the patients were over 50 years old, and most of them （91.7%） had underlying diseases. Abdominal pain （75.0%） and bloody stools （91.7%） were the most common presenting features; 57.6% of the bloody stool was bright red. 55.6% of the patients had abdomen tenderness and 80% of the tenderness had a relation with the disease location. All the patients were examined by colonoscopy, the most common lesions were located at the sigmoid （63.9%） and descending colon （52.8%）. All patients were treated with vasodilator drugs and comprehensive medical therapy, 22 patients healed and 14 improved, the average duration for healing or improving was 12 days. Conclusions： IC is mainly seen in the aged with acute abdominal pain and bloody stool as the main symptoms. Colonoscopy is helpful for diagnosis, and early diagnosis is the key for treatment. The prognosis is good in most cases and with rapid recovery.
出处
《胃肠病学》
2007年第10期585-588,共4页
Chinese Journal of Gastroenterology
