感染性结肠炎误诊为溃疡性结肠炎的临床分析.docVIP

精品论文 参考文献 感染性结肠炎误诊为溃疡性结肠炎的临床分析 何祥玉（旺苍县嘉川中心卫生院 四川广元628200） 【摘要】目的 探讨感染性结肠炎与溃疡性结肠炎的临床治疗方法 方法15例患者均运用中药及常规补液支持治疗．未使用水杨酸类或激素类药物，其中1例因粪便培养阳性合并口服喹诺酮类抗生素治疗(疗程1周)。结果15例患者分别在住院后3-6 d内便血停止，粪便性状恢复正常。在临床症状消失1-8周后复查肠镜，未见溃疡、糜烂、出血、水肿。15例患者随访6-12个月．未见症状复发，复查肠镜也未见异常。根据诊断性治疗的疗效，结合随访结果，确诊为Ic。 结论对于急性起病的便血患者，肠镜医帅应仔细观察并分析肠镜下表现，临床医师应从饮食史、伴随症状、相关病理表现等多方面进行综合判断 【关键词】感染性结肠炎；溃疡性结肠炎；临床分析；误诊 Infectious colitis misdiagnosed as ulcerative colitis clinical analysis He xiang yu 【Abstract】 Objective Of infectious colitis and ulcerative colitis treatment Methods15 patients were to support the use of traditional Chinese medicine and conventional rehydration therapy. Do not use salicylic acid or steroids, 1 patient with positive stool cultures combined oral quinolone antibiotics (treatment 1 week). Results15 patients were hospitalized 3-6 d after the cessation of blood in the stool, stool back to normal. Clinical symptoms disappeared in 1-8 weeks after endoscopy, no ulcers, erosions, hemorrhage, edema. 15 patients were followed up for 6-12 months. No recurrence of symptoms, review colonoscopy is no exception. According to diagnostic treatment efficacy, combined with follow-up results confirmed Ic. ConclusionL For patients with acute onset of hematochezia, colonoscopy doctors handsome colonoscopy should be carefully observed and analyzed under the performance of clinicians from diet history, accompanying symptoms, pathology and other aspects related to integrated to determine 【Key words】 Infectious colitis; ulcerative colitis; clinical analysis; misdiagnosed 【中图分类号】R574.62【文献标识码】A【文章编号】1007-8231（2011）06-0220-01 溃疡性结肠炎(UC)与感染性结肠炎(infectious colitis，IC)均为结肠性腹泻的常见原因,即使综合临床表现、内镜和组织学检查等表现,仍有部分UC与IC难以鉴别，溃疡性结肠炎(ulcerative colitis,UC)是一原因不明的主要侵犯结肠黏膜和黏膜下层的非特异性炎症,此病欧美发达地区发病率高,在我国随着生活水准的日益提高发病率也有升高,故对UC的警惕性较高,临床医生易将有些临床表现类似疾病误诊为UC. 1材料与方法 1.1一般资料:20091月-2010年9月我科住院患者中将IC误诊为uc者共15例，其中男6例．女9例；年龄32-52岁9例，52-61岁4例，65-80岁2例。15例患者均为急性起病，发病前均有不洁饮食史。均有下腹阵发性剧烈绞痛，腹痛后排干硬便或稀便，后出现便血。其中7例为黏液血便．2例为单纯