青年缺血性肠病5例误诊分析

目的:总结分析青年缺血性肠病误诊类型,旨在对青年人缺血性肠病有一定认识和警惕性,提高诊断率,及早治疗,降低死亡率。方法:回顾性分析我院2008年5月-2010年9月急诊误诊的5例青年缺血性肠病的原因及类型。结果:5例患者早期均未明确诊断,其中1例因误诊导致死亡。结论:青年缺血性肠病早期症状不典型,发病率低,易误诊,加强对其影像学及实验室检查表现的认识可减少误诊率。     

急性缺血性肠病25例临床分析

缺血性肠病也称肠系膜血管病,是由于各种原因引起的肠壁急性或慢性血流灌注不良所致的肠壁缺血性疾病。近年来随着人民生活水平的提高、人口老龄化明显及饮食结构等的改变,心脑血管疾病、糖尿病等发病率明显增加,缺血性肠病的发病率也随之增加[1]。缺血性肠病分为急性肠系膜缺血（AMI）、慢性肠系膜缺血（CMI）和缺血性结肠炎（IC）3类[2]。其中AMI及IC均为急性起病,也称急性缺血性肠病,     

缺血性肠病46例临床分析

随着心血管疾病发病率增加和人口的老龄化,缺血性肠病的发病率有增高趋势。缺血性肠病是由于各种原因引起的肠壁血流灌注不良所致相应肠道发生急性或慢性肠壁缺血性损害,此病可累及整个消化道,但主要累及结肠,     

梗死性缺血性肠病26例临床分析

缺血性肠病是由各种原因引起肠道供血不足而发生的综合征,根据缺血的程度分为梗死性和非梗死性缺血性肠病.多发生于老年人,早期诊断困难,病情发展迅速,病死率较高.随着人口老龄化,发病率逐渐增高,为减少误诊误治,现将我院手术确诊的26例患者进行分析.……     

急性缺血性肠病18例分析

目的总结急性缺血性肠病的临床特点。方法对2005—2010年确诊的18例急性缺血性肠病的临床资料进行分析。结果 18例患者早期均未明确诊断。结论缺血性肠病早期症状不典型确诊困难大,易误诊,从而延误诊疗。     

缺血性肠病的多层螺旋CT诊断价值

缺血性肠病是肠壁的缺血性病变,临床表现缺乏特异性,误诊率、病死率较高,早期诊断是影响预后的关键,而MSCT能显示缺血性肠病的可靠征象,逐渐成为缺血性肠病的一种重要诊断手段。     

老年缺血性肠病31例临床分析

随着社会人口老龄化、心血管疾病及糖尿病的增多,老年人缺血性肠病的发病率逐渐提高.近年来,我科收治老年缺血性肠病31例,现分析报告如下.     

肠脂肪酸结合蛋白及缺血修饰白蛋白联合检测对缺血性肠病的早期诊断价值

目的探讨肠脂肪酸结合蛋白(IFABP)与缺血修饰白蛋白(IMA)在缺血性肠病早期诊断中的价值。方法采用酶联免疫吸附法分别测定36例缺血性肠病患者、24例非缺血性肠病患者及20例健康体检者血清中IFABP、IMA水平。结果缺血性肠病组IFABP、IMA水平明显高于非缺血性肠病组及健康组(P0.05),二者联合检测时阳性率为88.89%,显著高于单项指标检测阳性率,差异有统计学意义(P0.05)。结论联合检测血清中IFABP、IMA水平对缺血性肠病早期诊断具有重要价值。     

缺血性肠病的临床特点及治疗

目的总结缺血性肠病,尤其是急性缺血性肠病的临床特点和治疗经验。方法回顾性分析该院自2002年2月～2006年11月间诊断及治疗的缺血性肠病患者共18例,其中急性发病患者共9例。结果18例患者中,手术治疗8例,介入治疗4例,保守治疗6例,17例患者痊愈出院,死亡1例。早期确诊率为50%。结论缺血性肠病早期症状不典型,确诊困难较大,容易延误诊断,预后较差。尤其是急性缺血性肠病病情重,进展快,死亡率很高。影像学检查对该病的早期诊断有较大帮助。     

缺血性肠病1例临床分析

缺血性肠病是指结肠和(或)小肠因供血不足发生的缺血性肠道损害,可分为急性肠系膜缺血、慢性肠系膜缺血及结肠缺血[1].随着社会人口老龄化的上升,缺血性肠病的发病率有增高的趋势.     

缺血性肠病34例临床分析

目的 探讨缺血性肠病的临床特点、治疗办法及预后.方法 回顾性分析34例缺血性肠病的临床表现、内镜特点、病理表现及治疗办法.结果 34例中有3例误诊,误诊率为8.8%;32例经内科保守治疗后治愈和缓解,2例手术治疗.结论 缺血性肠病以腹痛、便血、腹泻为主要表现.但缺乏特异性,误诊率高,对有相关心脑血管及糖尿病的老年患者,...     

缺血性肠病26例临床诊治分析

目的 探讨缺血性肠病的临床特征及诊断方法,进一步提高对该病的认识.方法 回顾性分析镇雄县人民医院住院治疗的26例缺血性肠病患者的临床资料.结果 26例患者中男16例,女10例,均有其他合并性疾病,其中伴发高血压、冠心病10例,糖尿病史7例,心瓣膜病5例,同时伴心房颤动2例、脑梗死1例、肝硬化1例.主要临床表现为腹痛、血便;24例行全结肠镜检查,确诊19例(79.2%);6例行CTA,确诊4例(66.7%);肠系膜动脉造影(DSA)12例,确诊7例(58.3%);16例行CT检查,确诊7例(43.8%);26例行彩色多普勒超声检查,确诊8例(30.8%).内科保守治疗24例有效,2例无效转外科手术治疗好转.结论 缺血性肠病绝大多数患者临床伴有其他基础疾病,由于临床症状和体征无特异性,误诊率和死亡率高.如及时行肠镜等辅助检查能早期发现及早期治疗,多数患者预后良好.     

老年人缺血性肠病27例临床表现和误诊分析

目的探讨老年人缺血性肠病的临床特点、误诊原因,提高对本病的认识和治疗效果。方法回顾性分析27例缺血性肠病的伴随疾病、临床表现、误诊原因、内镜特点及治疗方法。结果 27例中有9例误诊,误诊率为33.3%,25例给予内科保守治疗,手术和肠系膜血管溶栓治疗各1例,均治愈和缓解。结论缺血性肠病以腹痛、便血、腹泻为主要表现,缺乏特异性,误诊率高,在老年人有高血压、心血管病、房颤及糖尿病时发病率高。及时完善肠系膜血管造影及结肠镜检查,早期诊断,及时综合治疗是决定预后的关键。     

Cardiovascular disease mortality in Canada.

During the past two decades approximately one half of all deaths in Canada were due to cardiovascular diseases. Ischemic heart disease and cerebrovascular disease caused more than 60% and 20% of those deaths respectively. The mortality rates for ischemic heart disease in males increased slightly until 1965 and then dropped substantially, whereas the rates for females, which were declining at least since the early 1960s, accelerated in their decline. As a consequence, the rates for males remain almost twice as high as those for females. The reductions were initially observed in males 25 to 34 years old and in all age groups of females, but became apparent in a wider range of ages in the second period reviewed (1969 through 1977). The mortality of cerebrovascular disease has gradually diminished for both sexes since the 1950s, but the decline has been more pronounced among females, who originally had the higher rate. Marked geographic differences in mortality rates still exist in Canada despite the decline in death rates for both ischemic heart disease and cerebrovascular disease in all regions of the country. Surprising regional differences in times of onset of these declines have been demonstrated. For ischemic heart disease Ontario maintains the highest and the Prairies the lowest mortality rates. Quebec, despite a sustained decline, still ranks third, while the Pacific region shows the second-lowest rates in the country. The Atlantic region showed the lowest rates of decline in the period reviewed. The reduction in the mortality of ischemic heart disease in Canada (16.4% between 1969 and 1977) must be considered real for a variety of reasons. Direct evidence is not available to elucidate whether the reduction is the consequence of reduced incidence, increased survival or a combination of the two factors. The potential role of various factors that may have contributed to this decline is briefly discussed in this article.     

肠系膜上动脉病变致缺血性肠病的MSCT诊断

目的：回顾性分析多层螺旋CT在肠系膜上动脉病变致缺血性肠病的影像表现,为临床早期诊断提供依据。方法收集2012年8月至2015年8月在本院行CT检查并经临床证实的肠缺血患者6例,采用多层螺旋CT进行全腹CT扫描,其中4例增强扫描。以横断面原始CT图像加多种后处理技术进行肠系膜上动脉成像评价。结果6例患者中3例急性肠缺血,临床表现急性腹痛,3例均为肠系膜上动脉血栓,CT增强扫描显示肠系膜上动脉血栓,管腔内充盈缺损,轻度、中度狭窄,狭窄度介于50%左右。慢性肠缺血3例,表现为与进食有关慢性腹痛,肠系膜上动脉长段或局限性钙化狭窄。6例中2例发生轻症肠梗阻,肠管积气积液扩张,肠壁增厚模糊。6例患者临床非手术治疗,疗效明显。结论螺旋CT可以明确肠系膜上动脉病变致缺血性肠病的早期诊断,对临床治疗具有重要指导意义。     

系统性红斑狼疮并发缺血性肠病的诊治策略

目的 探讨系统性红斑狼疮(SLE)并发缺血性肠病(IBD)的诊治策略.方法 对12例SLE并发缺血性肠病患者的临床特点、腹部螺旋CT 扫描征象、实验室检查指标进行分析,并与30例不伴有腹部表现的SLE患者进行对比,并总结大剂量免疫球蛋白联合甲基强的松龙冲击对SLE并发缺血性肠病的效果.结果 12例SLE并发IBD患者均有发热、腹痛、腹肌紧张、腹部反跳痛、肠鸣音减弱,但均非SLE的首发表现.SLE并发IBD患者腹部螺旋CT 扫描显示两类异常征象:一类是肠壁异常,另一类是肠系膜水肿和血管增粗、增多以及异常的“梳状“或“栅栏样“血管排列.血补体C3及血白细胞计数较对照组明显降低,其他活动指标两组之间无显著差异.大剂量免疫球蛋白联合甲基强的松龙冲击治疗后IBD症状迅速缓解.结论 临床特征结合腹部螺旋CT 扫描可提高对SLE并发缺血性肠病的诊断符合率.SLE并发缺血性肠病多为腹部脏器小血管炎所致,多数不需要外科处理,及时给予免疫球蛋白联合甲基强的松龙冲击对缺血性肠病的效果明显.     

64排螺旋CT在缺血性肠病中的应用诊断

目的:探讨64排螺旋CT在诊断缺血性肠病的应用价值。方法:将20例缺血性肠病患者于发病后72h内行64排螺旋CT检查,扫描完成后采用最大密度投影、多平面重建、容积显示、曲面重建技术进行成像处理和分析。结果:64排螺旋CT能清楚、逼真的显示患者肠系膜血管及分支,其中肠系膜上静脉血栓患者9例,肠系膜上动脉栓塞患者5例,肠系膜上动脉夹层患者2例,肠系膜上动脉狭窄患者4例。结论:64排螺旋CT能为临床诊断和治疗缺血性肠病提供可靠的信息和依据。     

Chemoprevention and screening in primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease that causes fibrosis of the biliary tree. Life expectancy of patients is reduced by liver failure and a high incidence of malignancy. It is closely associated with inflammatory bowel disease, particularly ulcerative colitis, which coexists in approximately three-quarters of northern European patients. Cancers include cholangiocarcinoma, gallbladder cancer, hepatocellular carcinoma, pancreatic cancer and colorectal cancer. Ursodeoxycholic acid appears to reduce the incidence of colorectal neoplasia in patients with PSC, and there is some suggestion that it may also reduce the incidence of cholangiocarcinoma. A chemoprotective benefit of 5-aminosalicylates has not been confirmed in patients with PSC with associated inflammatory bowel disease. There is no accepted screening programme for cholangiocarcinoma, but methods for detecting early disease using biochemical markers, scanning using positron emission tomography or MRI, and endoscopic procedures such as endosonography and endoscopic retrograde cholangiopancreatography are discussed. A combination of techniques is often used in an attempt to diagnose early cholangiocarcinoma. Cholecystectomy should be performed for gallbladder polyps, as many are malignant, and ultrasonography and alpha-fetoprotein testing are suggested for screening for hepatocellular carcinoma. Colorectal carcinoma screening should be performed after the diagnosis of PSC, and surveillance colonoscopy should be performed annually if there is concomitant colitis.     

缺血性肠病临床特点和诊治的回顾性分析

目的：通过回顾性分析缺血性肠病的临床特点,以提高对该疾病的认识,明确诊断,减少误诊率。方法：收集长沙市第一医院消化内科及普外科收治的缺血性肠病患者40例,回顾性分析其临床表现、实验室检查、影像学检查、结肠镜检查及治疗经过。结果：缺血性肠病临床表现特点不明显,主要表现为腹痛、腹泻、便血、恶心、呕吐及发热等。所有患者经治疗后（包括两例血管外科手术及介入）均痊愈出院。结论：缺血性肠病多见于老年人,特别是高血压及动脉硬化,临床症状与体征无特异性,误诊率高。中老年人如出现不明原因的腹痛、腹泻、便血者,且腹痛伴有粪便隐血、D-二聚体阳性时,应怀疑本病,应尽早行血管彩色多普勒超声检查及结肠镜检查,必要时行血管 CTA 或造影等其他影像学检查。如能早期发现,及早治疗,多数患者预后良好。