白塞病及其消化道病变的外科处理

目的总结白塞病及其消化道病变的临床特征和外科治疗时机。方法对19例白塞病和有消化道病变病例的临床资料进行回顾性分析。对无外科并发症的病例按内科常规治疗。回肠穿孔1例行小肠部分切除术后转ICU治疗;结肠白塞病并慢性阑尾炎1例行阑尾切除术,因患者合并白血病术后转血液科;结肠白塞病无外科并发症1例确诊后转皮肤科治疗。结果白塞病确诊病例19例,除转ICU治疗的1例2d后自动出院外,其余18例均得到治愈或缓解,无死亡病例,其中15例(88．24％)得到随访,随访时间1个月～4年,死亡2例(合并白血病死亡1例,肺部感染致多器官功能衰竭死亡1例),其余13例中自塞病症状复发12例(92．31％),无外科并发症发生。结论白塞病内科治疗有效,但病情多反复发作,消化道病变少见,临床表现多样且不典型．发生穿孔者病情严重,临床应予重视,适时采取手术治疗。

Behcet''''s disease and its alimentary canal pathological changes by surgical treatment

Objective To summarize the Behcet's disease,its clinical characteristics of the alimentary canal pathological changes and the opportune moment of the surgical treatment.Methods The clinical data of 19 cases of Behcet's disease with pathological changes of alimentary canal from May 1999 to May 2003 were retrospectively analyzed.The cases without surgical complications were treated by physician;There were three cases of pathological changes of alimentary canal (15.79 %):One case of the ileum perforation was turned to ICU after the partial enterectomy;One case of colon Behcet's disease associated with chronic appendicitis was subjected to appendectomy and turned to the department of hematology after the operation due to leukemia.One case of colon Behcet's disease without surgical complications was turned to the dermatology section.Results 19 cases of Behcet's disease were certainly diagnosed.Except that a patient treated at ICU get out of the hospital in 2 days,the rest of 18 cases all were cured or alleviated.There was no death.15 cases (88.24 %) were followed up for 1 month to 4 years.Two patients were died (One of them died of leukemia and one died of the several organs function that was caused by the infection of lung).Of the remaining 13 cases,recurrence of Behcet's disease occurred in 12 cases (92.31 %) and no surgical complications were noted.Conclusion The medical treatment is effective for Behcet's disease,but recurrence develops easily.The alimentary canal pathological changes of Behcet's disease were rare and the clinical characteristics were not typical.The diseased condition in the cases of perforation was severe and appropriate surgical treatments were necessary.