结肠灌洗透析机治疗全结肠溃疡性结肠炎疗效观察

2005年12月～2008年8月采用结肠灌洗透析机对39例溃疡性急慢性结肠炎患者进行保留灌肠治疗,疗效显著,现报道如下。     

经结肠途径治疗仪保留灌肠治疗溃疡性结肠炎疗效观察

[目的]探讨经结肠途径治疗仪保留灌肠治疗溃疡性结肠炎的疗效。[方法]将120例溃疡性结肠炎患者分为治疗组和对照组,各60例。对照组行常规治疗,美沙拉嗪每日4g口服;治疗组在此基础上加用结肠途径治疗仪予甲硝唑100ml(0.5g)+硫糖铝4g+地塞米松5mg+庆大霉素8万U保留灌肠,每日1次;2组均15d为一疗程,共2个疗程。[结果]2个疗程后治疗组临床症状及内镜下表现明显优于对照组。[结论]经结肠途径治疗仪保留灌肠治疗溃疡性结肠炎疗效好,值得推广。     

结肠途径治疗机配合保留灌肠治疗溃疡性结肠炎疗效观察

目的观察思密达、柳氮磺胺吡啶（SASP）经结肠途径治疗机保留灌肠治疗溃疡性结肠炎（uc）的疗效。方法将60例UC患者随机分为治疗组和对照组各30例，分别给予思密达、SASP配合结肠途径保留灌肠治疗和口服思密达、SASP治疗。结果治疗组和对照组总有效率分别为96％和76．7％（P〈0．05）。结论思密达、SASP配合结肠途径保留灌肠治疗uc能有较好的效果。     

溃疡性结肠炎的外科治疗

溃疡性结肠炎(ulcerative colitis,UC)属内科治疗范畴,但有20%～30%的患者药物治疗无效或出现并发症,需手术治疗.现就UC外科治疗问题进行讨论.     

结肠宁对实验性溃疡性结肠炎的疗效观察

疡性结肠炎（ＵＣ）发病机制至今不明。近年研究表明氧自由基、炎症介质及细胞因子与ＵＣ肠粘膜损伤机制密切相关［１］。中药结肠宁（ＪＣＮ）临床治疗ＵＣ取得了良好疗效［２］,但缺乏实验研究。本文通过建立角叉菜胶性实验性ＵＣ豚鼠模型,观察了ＪＣＮ对实验性ＵＣ的治疗作用,并对其可能机制进行了探讨。１　材料与方法１．１　材料：健康雄性短毛豚鼠,体重２５０～３００ｇ,由同济医科大学实验动物学部提供。ＪＣＮ由党参、柴胡各１０ｇ,白术６ｇ,赤芍１２ｇ,黄连６ｇ等生药组成,用前制成汤剂,每１ｍｌ含生药３．２ｇ。Ⅱ型角…     

腹腔镜全结肠切除术治疗老年溃疡性结肠炎8例

有20%~30%的溃疡性结肠炎(UC)患者往往需手术治疗,老年人UC发病率虽不高,但病情严重,我科2009年3月至2011年5月共收治60岁以上UC患者8例均行腹腔镜全结肠切除术,疗效满意.     

结肠康灌肠治疗溃疡性结肠炎的实验研究

结肠康灌肠治疗溃疡性结肠炎的实验研究朱纯周，蔡昌学关键词结肠康，灌肠，溃疡性结肠炎，实验研究慢性溃疡性结肠炎是慢性非感染性肠道疾病，西医认为病因尚不十分清楚，可能与免疫、菌群失调、饮食不节、遗传等因素有关。我院用中药制剂结肠康灌肠液，治疗本病取得了较...     

复方苦参结肠溶胶囊治疗溃疡性结肠炎11例

[目的]观察复方苦参结肠溶胶囊对溃疡性结肠炎(UC)的治疗作用。[方法]将18例UC患者随机、单盲、阳性平行对照分为复方苦参结肠溶胶囊组(治疗组,11例)和柳氮磺吡啶组(对照组,7例),服药时间均为8周。对比观察2组患者服药前后的症状、体征、大便常规、结肠镜和病理检查,并监测肝肾功能、血尿常规、心电图等变化。[结果]治疗组症状、体征、大便常规、结肠镜和病理检查结果评分均优于对照组(P<0.05)。[结论]复方苦参结肠溶胶囊对UC有较好的治疗作用,且无明显的不良反应,值得临床推广运用。     

胶囊结肠镜对结肠黏膜炎症性改变的诊断价值初探

目的 探讨胶囊结肠镜下结肠黏膜损伤的内镜影像学特点对诊断溃疡性结肠炎的临床价值.方法 连续收集2009年7月至2010年6月间19例患者,其中男12例、女7例,平均年龄（44.2±14.6）岁,入组者以血便、腹泻、腹痛为主要临床表现,具备溃疡性结肠炎相关诊断依据.研究中将胶囊结肠镜和传统结肠镜下结肠黏膜病变严重程度分为轻、中、重三级,以传统结肠镜诊断为金标准,统计胶囊结肠镜与传统结肠镜下黏膜分级的一致性（Kappa值和P值）,并同时观察胶囊结肠镜检查过程中肠道清洁度、全结肠检查完成率、患者不良反应等情况.结果 胶囊结肠镜下黏膜轻度病变2例,中度8例,重度9例 而传统结肠镜下则轻度3例,中度8例,重度8例.经统计Kappa=0.826,确切概率计算P＜0.001,提示一致性良好.胶囊内镜全结肠检查完成率达100%（19/19）,肠道清洁度优良率达79%（15/19）,检查全过程中未出现明显不良反应.结论 胶囊结肠镜能客观反映溃疡性结肠炎患者黏膜病变程度,具有部分替代传统结肠镜进行结肠病变监测的价值.     

Fifteen-year-old colon cancer patient with a 10-year history of ulcerative colitis

Inflammatory bowel disease (IBD) is regarded as one of the risk factors for colorectal cancer, and early detection of cancer in these patients may be difficult, especially in pediatric patients. Prognosis of pediatric colorectal cancer is known to be poor, because of delayed diagnosis and unfavorable differentiation. We report a case of a pediatric patient with a 10-year history of ulcerative colitis who was diagnosed with sigmoid colon cancer when he was 15 years old. He underwent proctocolectomy with ileal pouch anal anastomosis. Postoperative pathological examination of the tumor revealed adenocarcinoma. The pericolic tissue layer was infiltrated, but metastases were not found in either of the two lymph nodes. Children with a long history of predisposing factors such as IBD need particular attention to the possibility of colorectal cancer. Early diagnosis through regular screening with colonoscopy is one of the most important critical factors for a good prognosis.     

Early aggressive therapy for severe extensive ulcerative colitis

The current ulcerative colitis （UC） treatment algorithm involves a step-up therapeutic strategy, mainly aiming at inducing and maintaining its clinical remission. Although this therapeutic strategy may seem to be cost-efficient and reduce the risk of side effects, recent trials and case reports have shown that top-down therapy using infliximab induces a rapid clinical response, enhances patient quality of life, promotes mucosal healing, reduces surgeries and indirect cost of treatment for patients with severe UC. Moreover, since long-term treatment with infliximab is safe and well tolerated, early aggressive top-down therapeutic strategy may be a more effective approach, at least in a subgroup of severe extensive UC patients.     

溃疡性结肠炎与感染性结肠炎综合积分的研究

目的：比较溃疡性结肠炎(UC)与感染性结肠炎(IC)在临床、内镜及组织学等方面的不同，为鉴别UC和IC提供量化的综合鉴别指标，建立积分标准。方法：将1996-2001年在四川大学华西医院住院诊断明确的127例UC和143例IC患者作为研究对象，建立鉴别UC与IC的积分系统。结果：临床积分标准(包括实验室检查)ROC曲线下面积0．990，Youden指数0．903，敏感性为94．5％，特异性为95．8％。组织学表现积分各值分别为0．978、0．864、93．5％和92．9％。临床和内镜综合积分各值分别为0．997、0．954、97．8％、和97．6％。临床、内镜及组织学综合积分各值分别为0．999、0．976、100％和97．6％。结论：通过量化UC和IC临床表现、实验室检查、内镜、组织学等各项有鉴别意义的指标而建立的UC积分诊断标准具有良好的诊断价值。     

趋化因子与溃疡性结肠炎

趋化因子是控制细胞定向迁移的细胞因子,其功能由趋化因子受体介导.在溃疡性结肠炎中,许多趋化因子及部分受体表达增加,并在发病机制上起重要作用.针对趋化因子及其受体的靶向治疗能减轻炎症损伤,有望成为一种新的溃疡性结肠炎治疗方法.     

溃疡性结肠炎各阶段治疗策略

目的溃疡性结肠炎(ulcerative colitis,UC)是基于多因素影响而产生的结肠非特异性炎症,目前尚无特效方法治愈。该病表现复杂、转归复杂、治疗方案复杂,对医师的临床技能要求很高。本文针对UC不同阶段表现以及处理原则及手段进行剖析,并结合自身经验对UC不同阶段的治疗方案进行点评、阐述。     

A rare extraintestinal manifestation of ulcerative colitis: Tracheobronchitis associated with ulcerative colitis

We describe a 44 year-old woman who presented with dyspnea and cough 5 years after initial diagnosis of ulcerative colitis. The evaluation of patient showed findings of large airway inflammation with tracheal wall thickening and mucosal irregularities. The etiology was investigated and was diagnosed as tracheobronchitis that is a rare extraintestinal manifestation of ulcerative colitis. She was treated with systemic corticostreoids and rapid clinical improvement was detected.     

Effects of oral tacrolimus as a rapid induction therapy in ulcerative colitis

AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)patients.METHODS:This was a prospective,multicenter,observational study.Between May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively enrolled.All patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per day.The dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 wk.Induction of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at onset.Within the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment initiation.At 2wk,73.1%of patients experienced clinical responses.After tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,respectively.Treatment was well tolerated.CONCLUSION:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment initiation.Rapid induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.     

Biological therapy for ulcerative colitis: An update

Of the diverse biological agents used for patients with ulcerative colitis, the anti-tumor necrosis factor-α agents infliximab and adalimumab have been used in large-scale clinical trials and are currently widely used in the treatment of inflammatory bowel disease patients. Recent studies have indicated that golimumab, oral tofacitinib and vedolizumab reportedly achieved good clinical response and remission rates in ulcerative colitis patients. Thus, we believe that the detailed investigation of various studies on clinical trials may provide important information for the selection of appropriate biological agents, and therefore, we have extensively reviewed such trials in the present study.