炎症性肠病.赵海龙.pptVIP

三、手术治疗 完全性肠梗阻、瘘管、腹腔脓肿、 急性穿孔、不能控制的大量出血 实用内科学.第13版.2010 陆再英,内科学第7版,419 手术适应证 （针对并发症） 切除 病变肠段 术后复发率高 预后 陆再英,内科学第7版,419 实用内科学.第13版.2009 谢谢 UC Summary 1. What does the development of ulcerative colitis associate with ？ Remain unknown Immunological response Heredity 2. Where does the disease often affect？ Rectum and sigmoid mucosa UC Summary 3.What are the main clinical manifestation of the disease？ Local manifestation： Systematic manifestations Colonic diarrhea Abdominal pain 4. What are the main complications of the disease？ UC Summary Toxic megacolon Heamorrhage Cancer Pseudopolyp 5. What dose the diagnosis depend on？ Clinical feature / Endoscopic and radiographic findings Excluding intestinal infectious disease, cancer, Crohn s disease and so on. 6. What are the main treatments? UC Summary SASP 5-ASA Corticosteroide Drug enema Azathioprne Cyclosporine A CD Summary 1. What does the development of Crohn`s disease associate with? Remain unknown Immunological response Heredity 2. Where does the disease often affect? Terminal ileum colon ascenders CD Summary What are the main clinical manifestations of the disease? Local manifestation Abdominal pain Small bowel diarrhea Abdominal mass Systematic manifestations Fever Malnutrition Extra-intestinal features 4. What are the main complications of the disease? CD Summary 5. What dose the diagnosis depend on? Intestinal obstruction Fistula Abscess Clinical feature Endoscopic and radiographic findings Excluding intestinal Tuberculosis, cancer, ulcerative colitis and so on. 6. What are the main treatments? CD Summary SASP Corticosteroide Azathioprne Antibiotics 肠道生理我们已经简要介绍了，我们今天所讲的炎症性肠病，它的定义为： IBD是一组病因不明的肠道慢性非特异性炎症性疾病。包括：溃疡性结肠炎（ Ulcerative coltitis, UC）和克罗恩病(crohn’s disease, CD）。 溃疡性结肠炎是结肠黏膜层和黏膜下层性炎症，疾病先通常累及直肠，逐渐向全结肠蔓延； 克罗恩病可累及全消化道，为非连续性全层炎症，最常累及部位为末端回肠、结肠和肛周。 注：我们讲的是狭义炎症性肠病，而广义的炎症性肠病：是以肠道炎症为