小肠克罗恩病60例治疗分析.docVIP

小肠克罗恩病60例治疗分析 　　[摘要] 目的 探讨小肠克罗恩病的临床特征及诊治经验。 方法 回顾性分析2006年1月～2013年1月复旦大学附属华山医院静安分院收治的小肠克罗恩病患者的一般资料、临床表现、辅助检查、治疗等相关临床资料。 结果 本研究共纳入60例小肠克罗恩病患者，男女比例2.53∶1，年轻患者多见，慢性起病；临床表现以腹痛腹泻为主，结肠镜及小肠钡灌肠是主要的检查手段；内科治疗后症状多能改善，外科治疗多针对穿孔、出血、梗阻等并发症。 结论 小肠克罗恩病临床表现多样，易漏诊误诊，应结合症状、影像资料及内镜检查结果进行综合判断。 　　[关键词] 克罗恩病；小肠；回顾性研究；诊断；治疗 　　[中图分类号] R574.5 [文献标识码] A [文章编号] 1673-7210（2014）01（b）-0050-03 　　Treatment analysis of 60 patients with small bowel Crohn disease 　　GU Erli 　　Department of Gastroenterology， Jingan Branch， Huashan Hospital Affiliated to Fudan University， Shanghai 200040， China 　　[Abstract] Objective To investigate the clinical characteristics， the experience of diagnosis and treatment of small intestinal Crohn disease. Methods The general data， clinical manifestation， auxiliary examination and treatment of patients with small intestinal Crohn disease admitted in Jingan Branch， Huashan Hospital Affiliated to Fudan University from January 2006 to January 2013 were retrospectively reviewed. Results 60 patients had been enrolled， ratio of male to female was 2.53∶1， more common in younger patients and chronic onset. The main symptoms were abdominal pain and diarrhea. Colonoscopy and small intestinal barium enema were the main means of checking. The symptoms of patients were under control with medical treatment， and patients accepted surgery when gastrointestinal tract perforation， bowel obstruction and perforation happened. Conclusion Small bowel Crohn disease may cause diversity of clinical manifestations. Diagnosis of small bowel Crohn disease needs a combined course that integrates with all valuable clinical evidences and clues. 　　[Key words] Crohn disease； Small bowel； Retrospective studies； Diagnosis； Treatment 　　克罗恩病是一种非特异性的胃肠道慢性炎性肉芽肿疾病，病变可累及口腔至肛门的各段消化道，多见于末端回肠[1]。研究表明，我国克罗恩病的发病率正逐年上升[2]。早期诊断是临床上决定治疗方案，提高疗效，改善预后的重要基础[3]，但克罗恩病的临床表现多样，辅助检查特异性不高，给临床诊断造成困境，尤其是当病变单纯位于小肠时，由于目前针对小肠的检查手段有限，因此小肠克罗恩病的早期诊断率并不高[4]。本研究回顾性分析了近几年复旦大学附属华山医院静安分院（以下简称“我院”）收治的小肠克罗恩病患者的临床诊治资料，以提高对此病的认识和诊断水平。