暴发性溃疡性结肠炎临床诊治现状

暴发性溃疡性结肠炎(FUC)的确切定义尚待进一步明确。临床诊断除依据发热、大量黏液脓血便、腹痛、腹胀、严重毒血症以及粪便细菌培养阴性外,应强调内镜检查、肠黏膜破坏和溃疡特征的重要意义。临床处理FUC时,内外科必须紧密合作,采用重症监护、营养支持、输血和输血制品、皮质类固醇、环孢素或英夫利昔等急救措施。如内科治疗无效或出现并发症,应及时行外科治疗。

Current Diagnaosls and Management of Fulminant Ulcerative Colitis

The definition of fulminant ulcerative colitis （FUC） has not yet been settled unanimously. Emphasis of its diagnosis should be placed on the characteristics of intestinal mucosal damage and ulcers demonstrated by endoscopy, despite the presence of fever, large amount of bloody diarrhea, abdominal pain, distention, severe toxemia and negative fecal bacterial culture. In its management, close cooperation between physicians and surgeons is necessary; critical care, nutrition support, transfusion of blood and blood product, corticosteroids, cyclosporin or infliximab are essential. Colectomy is considered as final rescue in case the patient is refractory to medical treatment or with the emergence of serious complications.