激素在溃疡性结肠炎的应用.ppt

Two parts The introduction of Ulcerative colitis The clinical application of Corticosteroids in Ulcerative colitis Ulcerative colitis Definition: Chronic non-specific colitis Inflammation of the mucosa and submucosa of the large intestine Features: diarrhea with feces containing mucus, pus and blood, abdominal pain and tenesmus; and recurrence is common Mostly seen in 20-50 years of age, and in Europe Less common in China Infiltration of lymphocytes, plasma cells, eosinophilic cells and neutrophilic cells in mucosa Cryptic abscess and superficial ulcers Inflammatory polyps or pseudopolyps; Clinical Manifestations Systemic manifestations fever,tachycardia,Anemia, malnutrition, volume depletion, disturbance in acid-basebalance and hypoalbuminemia in advanced patients Extra-intestinal manifestations erythema nodosum, arthritis, ankylosing spondylitis, iritis，episcleritis, conjunctivitis, ulcers of oral mucosa, chronic active hepatitis and so on. erythema nodosum C.range classification Proctitis or proctosigmoiditis:40-50% Left-sided or intermediate colitis :30-40% Pancolitis:20% D.period classification Active phase Alleviative phase endoscopic examination Diseased mucosa: hyperemic and edematous, blood vessels not clear-cut, mucosa erosions and multiple shallow ulcers; rough, fragile, bleeding easily granular, pus; pseudopolyps seen Second part The clinical application of Corticosteroids in Ulcerative colitis Finding CORTISONE IN ULCERATIVE COLITIS FINAL REPORT ON A THERAPEUTIC TRIAL Conclusion the patients receiving cortisone enjoyed a clear-cut advantage over the patients on a dummy preparation. About two out of every five patients on cortisone therapy were in clinical remission at the end of six weeks treatment, compared with less than one out of every six patients receiving the inert therapy. Among the patients treated with cortisone those in their first attack have fared somewhat