32例缺血性结肠炎与45例溃疡性结肠炎对比分析.docVIP

精品论文 参考文献 32例缺血性结肠炎与45例溃疡性结肠炎对比分析 唐映 广州番禺区中心医院消化内科 511400 摘要：［目的］：总结缺血性结肠炎(IC)与溃疡性结肠炎(UC)鉴别要点。［方法］：回顾分析2006 年7 月－2012 年12 月我院32 例IC 和45 例UC 患者资料，对 性别、发病年龄、病程、基础疾病、临床症状、肠镜表现、病理结果、复查情况，进行对比分析。［结果］：IC 以老年女性居多，基础疾病多，多表现为突发腹痛、 腹泻、便血，病程短，有自限性，肠镜下病变多累及一侧肠腔，直肠少受累，呈节段性分布，病理结果以慢性炎症为主，小血管纤维素血栓形成，少见中性粒细 胞浸润，2 周后复查肠镜，镜下炎症明显消失。UC 病程长，腹痛不明显，粘液血便为特异表现，镜下病变呈连续性，多源于直肠，溃疡与炎性增生并存，病理学 表现为大量中性粒细胞等多种细胞浸润，典型者可见隐窝脓肿，2 周后复查肠镜，仍可见溃疡面。［结论］：IC 与UC 极为相似，应全面结合病史及内镜特点进行诊 断。 关键词：缺血性结肠炎；溃疡性结肠炎；治疗前后；对比分析 Abstract:［Objective］:To study on differences of clinical and histopathologic features between ischemic colitis(IC) and ulcerative colitis(UC). ［Methods］:Comparative analyses are focus on the clinical and histopathologic data of ischemic colitis patients(32cases) and ulcerative colitis patients (45eases) form July.2006 to Dec. 2012, such as age, course of diseases, underlying diseases，symptoms，colonoscopic and histopathologic findings. ［Results］:IC Patients are elder than UC patients, and tend to have history of cardiovascular diseases. The tylpical clinical manifestations o IC are sudden onset of abdominal pain, hematochezia and diarrhea, but UC usually presents with abdominal Pain，diarrhea，bloody mucopurulent stool. Colonoscopy shows that IC lesion involved only a single segment and rectum is rarely involved; on the contrary, the ulcer of UC is usually map-like. The lesion is originated from rectum with continuons mucosal inflammation. Cryptitis is frequenly seen in UC. Under therapy of two weeks, we can find that inflammation is released objectively in IC through colonoscopy. ［Conclusions］: we should make a comprehensive analysis of clinical and endoscopic features, for providing a basis for the identification of IC and UC. Key words: Ischemic colitis; Ulcerative colitis; Comparative analysis; Difference; Therapy 缺血性结肠炎(ischemic colitis，IC)是结肠血液供应不足或回流受 阻导致肠壁缺血缺氧损伤所引起的急性或慢性肠道病变。随着医学 发展以及患高血压病、糖尿病、高脂血症人群日益增多，IC 也越来 越多见。IC与溃疡性结肠炎(ulcerative colit