中国实用外科杂志

中国实用外科杂志 ›› 2005, Vol. 25 ›› Issue (09): 1-520.

• 论蓍 •    下一篇

炎症性肠病135例临床分析

杜俊东 李基业 黎沾良   

  1. 中国人民解放军总医院第一附属医院普外科(北京，100037)
  • 收稿日期:2005-05-01 修回日期:2005-06-22 出版日期:2005-09-20 发布日期:2005-09-20

  • Received:2005-05-01 Revised:2005-06-22 Online:2005-09-20 Published:2005-09-20

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摘要：

目的 探讨溃疡性结肠炎(UC)和克罗恩病(CD)的诊断和治疗方法。方法 回顾性分析1985~2004年的135例符合中华医学会消化病分会制定的炎症性肠病诊断治疗规范标准的病人的临床、肠镜及治疗方法和效果。结果 31例CD主要临床症状为糊状腹泻, 腹痛多位于脐周或右下腹，内镜下主要表现为节段性、非对称性的黏膜炎症，阿弗他溃疡。104例UC主要表现为反复发作的黏液脓血便，腹痛多位于下腹和左侧，内镜下主要表现为多发性浅表溃疡、弥漫性充血糜烂、 假息肉。UC结肠镜确诊率为100%,但CD结肠镜确诊率仅为419%。UC内外科治疗完全缓解率336%,有效率82.7%;CD完全缓解率为226%,有效率为645%,UC的治疗有效率明显高于CD(P＜005＝。结论 结肠镜是诊断UC的最有效方法,CD的诊断须依靠临床、内镜、X线及手术探查资料进行综合评价。合理的内科治疗和选择性外科治疗可提高IBD治疗效果。

Abstract:

Clinical analysis with inflammatory bowel diseas :Experience of 135 cases. Du Jundong,Li Jiye,Li Zhanliang.Department of General Surgery,The First Appiliated Hospital of General Hospital of PLA, Beijing 100037,China Abstract Objective To investigate the modalities of diagnosis and treatment of Ulcerative colitis(UC) and Crohn s disease(CD). Methods According to the diagnosis and treatment criteria of inflammatory bowel disease(IBD) established by Digestive Branch of Chinese Medical Association,135 cases with IBD from 1985 to 2004 were analyzed retrospectively in the aspects of clinical presentation,endoscopic findings，therapeutic modality and outcomes. Results CD (31 cases) mainly manifested pasty diarrhea and had abdominal pain in periumbilicus or low right quadrant of the abdomen;Main endocopic findings were segmental, nonsymmetric mucositis and aphthous ulcers. UC( 104 cases) mainly manifested recurrent mucopurulent bloody stool and had abdominal pain in the low and left of the abdomen; main endoscopic findings were multiple superficial ulcers, diffuse congestive erosion and pseudopolyps. The confirmed diagnosis rate of endoscopy was 100% in UC while 419% in CD. Completed remission rate and effective rate of medical and surgical therapy were 336% and 827% respectively in UC while 226% and 645% in CD,the former was remarkably higher than the latter(P＜005＝. Conclusion Endoscopy is the most effective modality for diagnosing UC, diagnosis of CD should however undertake comprehensive assessment of clinical, endoscopic, radiological and operative data. Rational medication and selective surgical intervention can improve the outcomes of IBD.

Key words: Inflammatory bowel diseas Ulcerative colitis Crohn&rsquo, s disease