缺血性结肠炎56例结肠镜及临床特点分析

目的 研究缺血性结肠炎的临床特点、结肠镜特征及诊治要点.方法 回顾性分析56例缺血性结肠炎的临床资料及结肠镜特征.结果 缺血性结肠炎好发于老年人,多有相关基础疾病,女性多于男性(2.5%vs 1.4%,P＜0.05),主要表现为急性腹痛、便血及腹泻.结肠镜检查:结肠脾曲、降结肠及乙状结肠最容易受累.病变黏膜和正常黏膜分界清楚,表现为黏膜苍白水肿、瘀斑、黏膜下出血、糜烂以及溃疡.多表现为一过性,若能早期诊断治疗,预后良好.结论 具有心、脑血管疾病或糖尿病的老年患者出现急性腹痛、便血、腹泻,应考虑可能合并缺血性结肠炎,及时行结肠镜检查.结肠镜检查在明确诊断、早期治疗和判断预后上有重要意义.

Colonoscopic and clinical study on 56 cases of ischemic colitis

Objective To investigate the clinical, endoscopic features and main diagnosis points of ischemic colitis. Methods Fifty-six cases of ischemic colitis were retrospectively analyzed, especially on the clinical and endoscopic characters. Results Ischemic colitis was most common in old people,especially those with history of related underlying conditions. It was more easily involved in female than in male,the detecting rate was 2.5 % vs 1.4 % （ P 〈 0.05）. Important manifestations were lower abdominal pain and hemafecia. Endoscopic findings showed main lesions in left colon with appearance of severe mucosal edema, congestion, erosion, necrosis and ulceration. In most cases, clinical features were transient and patients had better prognosis as early diagnosis and treatment were given. Conclusion Ischemic colitis should be considered for elderly patients complaining acute abdominal pain and hemafecia with previous cardiovascular disease, cerebrovascular disease and diabetes. Endoscopies are very important to obtain the accurate diagnosis and early treatment and prognosis of assessment.