溃疡性结肠炎治疗探讨（附115例报告）

本文对115例溃疡性结肠炎(UC)的治疗进行探讨，男性63例(54．8％)，女性52例(45．2％)，年龄在18—55岁之间，18—35岁94例(81．7％)，36—55岁21例(18．3％)，青年发病位于第一位。轻度72例(62．6％)，中度38例(33．0％)，重度5例(4．4％)。慢性复发型67例(58．3％)，慢性持续型39例(33．9％)，急性爆发型2例(1．7％)，初发型7例(6．1％)。活动期81例(70．4％)，缓解期34例(29．6％)。并发症27例(23．5％)。对UC要坚持分级、分期、分段和长期治疗的原则，这是UC是否能够治愈的关键。对合并细菌感染者加用抗生素可收到较好的疗效。对慢性复发型和慢性持续型病人，常规使用叶酸-Folicacid可以防止癌变。经正规治疗后完全缓解42例(36．5％)，有效70例(60．9％)，无效3例(2．6％)．总有效率112例(97．4％)。     

多层螺旋CT在溃疡性结肠炎中的应用

回顾性分析2011年1月-2012年1月在我院治疗的96例溃疡性结肠炎患者的治疗资料,所有患者均进行多层螺旋CT平扫和双期增强扫描。结果常规窗宽窗位显示黏膜强化84例,黏膜气下泡影8例,肠壁增厚96例,肠壁水肿分层72例;改良后窗宽窗位显示黏膜强化4例,黏膜气下泡影64例,肠壁增厚96例,肠壁水肿分层6例;多平面重组图像显示病变范围,全结肠者8例,左半结肠者20例,横结肠10例,直肠和乙状结肠者62例。肠壁水肿分层、结肠壁增厚等临床CT诊断结肠炎敏感性较高,黏膜强化、黏膜气泡影诊断UC（溃疡性结肠炎）特异性较高,使用不同窗宽窗位和MPR图像利于UC诊断及显示病变范围。     

溃疡性结肠炎104例分析

溃疡性结肠炎是一种病因未明的炎症性肠病,我院自1981年以来收治住院及门诊患者104例,就其临床表现、并发症、诊断、治疗进行探讨,目的在于提高对本病的认识、早期诊断、早期治疗、防治并发症、降低病死     

儿童溃疡性结肠炎8例分析

溃疡性结肠炎的病因较为复杂。与感染、免疫异常、环境因素及遗传等多种因索有关。对我院1995～2004结肠镜检查诊断溃疡性结肠炎（UC）8例分析如下。     

35例溃疡性结肠炎的误诊分析

目的：分析近10年我院UC住院例的误诊情况。方法：收集我院1989年1月-1999年1月的误诊UC病例并评价其临床资料。结果：被误诊UC病例共35例。男19例,女16例,男/女为1.2/1,平均年龄41岁,平均病程4.5年,疾病类型以初发型为多。占42.9%。临床症状以腹泻,便血常见,内镜下以肠粘膜充血,水肿、糜烂,浅溃疡多见。内镜诊断率71.4%,病理活检诊断率28.6%,被误诊的疾病中,细菌性痢疾和阿米巴痢疾最常见。占54.3%。结论：感染性肠病仍是诊断UC时最重要的鉴别疾病。     

婴儿溃疡性结肠炎1例

溃疡性结肠炎在欧美国家发病率较高,近 10年来,东南亚地区包括我国的发病率呈明显上升趋势,特别是小儿溃疡性结肠炎多呈急骤起病,作者对 1例婴儿溃疡性结肠炎诊治分析如下.     

小儿溃疡性结肠炎2例误诊分析

小儿溃疡性结肠炎２例误诊分析宜春医学专科学校（３３６０００）江晓云小儿溃疡性结肠炎并非罕见，但早期易与多种肠道疾病混淆而误诊，延误治疗，笔者曾遇２例，现报告分析如下。１病例介绍例１男，１１岁，因反复腹痛、腹泻、便血１年，加重伴发热４个月入院。曾以“急...     

溃疡性结肠炎13例诊断分析

现将我院1994～2007年收治的经病理证实的溃疡性结肠炎13例分析如下。 1临床资料 1．1一般资料本组男7例，女6例，年龄21～77岁，平均48岁，病程1～16a。就诊时，临床症状表现为不同程度的腹泻（4--6次／d）、腹痛（多在左下腹痛），其中合并脓血便4例，贫血3例，发热9例，口腔溃疡5例，角膜溃疡2例，混合痔2例。     

溃疡性结肠炎129例临床分析

溃疡性结肠炎简称溃结 ,本病在欧美发病率相对较高 ,国内较低 ,但近年来有上升趋势。本文收集１９８９～１９９９年来在浙江大学医学院附属第二医院就诊资料完善的病人１２９例 ,分析如下。临床资料一、一般资料本组１２９例 ,男７９例 ,女５０例 ,男女比例为１．５８:１。年龄１５～７０岁 ,平均年龄４３．０４岁 ,１０～２０岁５例 ,２０～３０岁２３例 ,３０～４０岁２６例 ,４０～５０岁３４例 ,５０～６０岁２８例 ,６０岁以上１３例。病程最短半月 ,最长１５年。其中＜１年４１例 ,１～５年４８例 ,６～１０年２８例 ,＞１０年１２例…     

106例溃疡性结肠炎的内镜和临床分析

溃疡性结肠炎 (ｕｌｃｅｒａｔｉｖｅｃｏｌｉｔｉｓ,ＵＣ)是一种病因尚未明确的慢性疾病 ,以大肠粘膜与粘膜下炎症为病变的主要特征。近年来发病率有上升趋势。我科近 8年来共诊治 10 6例ＵＣ患者。本文对其进行临床分析 ,探讨ＵＣ的特点及内镜在诊断中的作用。1　临床资料1.1　一般资料我院 1992～ 1999年收治的ＵＣ10 6例 ,均经结肠镜检查及病理证实[1] 并符合 1993年全国慢性非感染肠道疾病学术研讨会标准 ,均经结肠镜检查及病理证实[1] 。其中男性 5 1例 ,女性 5 5例 ,年龄 16～ 74岁 ,平均 41.8岁 ,病程短于 1年37例 (34.9% ) ,1～ 10…     

特发性肠系膜静脉硬化性结肠炎多层螺旋CT表现

特发性肠系膜静脉硬化性结肠炎(idiopathic mesenteric phlebosclerotic colitis,IMP)又称静脉硬化性结肠炎或肠系膜静脉硬化病,是罕见的缺血性结肠炎[1],主要特征为肠系膜静脉及其属支和结肠壁内静脉管壁增厚钙化、管腔狭窄闭塞,并继发结肠肠管(以右半结肠为著)缺血表现.本病临床症...     

Granulocyte migration in ulcerative colitis

Although histologically relapses in ulcerative colitis are characterized by an intense granulocyte infiltrate, there is evidence both from in vitro function tests and skin window migration studies in vivo that there is defective granulocyte function in ulcerative colitis. We have recently developed a method for non invasively monitoring granulocyte migration to sites of inflammation using indium-111-labelled granulocytes, and have used this technique in fifteen patients with ulcerative colitis. In all fifteen cases there was rapid migration of indium-111-labelled granulocytes to inflamed bowel within 10 min of return of the labelled cells. This study provides no support for a significant granulocyte migration defect in ulcerative colitis.     

30例溃疡性结肠炎患者的护理

目的探讨溃疡性结肠炎的护理方法。方法对30例溃疡性结肠炎患者的临床资料进行回顾性总结,分析其临床特点与诱因,有针对性地做好心理护理,提高患者的依从性,加强营养支持,必要时静脉营养,做好用药指导,确保患者长期、正确用药,在溃疡性结肠炎活动期加强病情观察,及时发现各种并发症。结果 24例患者均好转出院,门诊长期随访,目前有6例反复发作。结论溃疡性结肠炎病程漫长,常反复发作,督促患者长期、准确用药,定期复查,能维持长期缓解,减少并发症的发生。     

溃疡性结肠炎的肠外表现特点分析

目的 分析溃疡性结肠炎(UC)患者肠外表现的临床特点.方法 对我院2002年1月至2007年2月的205例UC患者的临床资料进行回顾性分析.结果 肠外表现特征中骨关节病变和口腔病变发生率最高(均为6.83%,14/205).<40岁的患者肠外表现发生率(41.30%,38/92)明显高于40岁以上(21.24%,24/113)的患者(均为P<0.01);男(28/62)女(34/62)患者肠外表现发生率无明显差异(P>0.05);全结肠型肠外表现发生率(55.0%,44/80)明显高于左半结肠型(16.3%,8/49)、直乙状结肠型(13.2%,10/76),差异有统计学意义(P<0.05);活动期肠外表现发生率(32.6%,59/181)明显高于缓解期(12.5%,3/24),差异有统计学意义(P<0.05);轻(9.5%,7/74)、中(27.0%,17/63)、重度(55.9%,38/68)患者肠外表现发生率差异有统计学意义(P<0.05),从轻度、中度至重度呈递增趋势;病程5年以上组肠外表现发生率(39.3%,35/89)明显高于病程小于5年组(23.3%,27/116),差异有统计学意义(P<0.05).结论 溃疡性结肠炎患者肠外表现发生率较高,累及的部位依次是口腔、关节、肝胆、皮肤、眼睛.肠外表现的发生随年龄、病变范围、活动性、严重程度、病程增加有增多的趋势.     

糖皮质激素在溃疡性结肠炎治疗中的合理应用

糖皮质激素能有效诱导活动性溃疡性结肠炎缓解,同时伴有诸多的不良反应。由于大规模随机对照临床研究的缺乏,糖皮质激素在溃疡性结肠炎治疗中的应用标准模式尚不清晰。降低糖皮质激素使用风险,最大化其疗效需要选择适合人群,在适当时机给予恰当药物。本文结合近年发表的专家共识意见,探讨溃疡性结肠炎治疗中糖皮质激素的合理应用。     

Application of color Doppler ultrasonography to ulcerative colitis

We used color Doppler ultrasonography (US) to evaluate bowel wall thickening in ulcerative colitis and to determine the value of this modality in this application. Twelve patients (6 men and 6 women) with ulcerative colitis underwent both gray-scale and color Doppler US. Bowel wall thickness and wall echotexture were recorded by gray-scale US, and the presence of intramural color Doppler flow and arterial signal were evaluated by color Doppler US. Color Doppler flow was graded as ‘weak’ or ‘abundant’, and resistive index was calculated; clinical severity of disease activity was also graded, and serum CRP level was measured. Variation in serum CRP levels and intramural color Doppler flow according to clinical severity, and the correlations between serum CRP levels and the number of blood flow signals were statistically significant. In 10 of the 12 patients, analysis of the Doppler waveform showed an arterial blood flow signal, and mean resistive index value was determined to be 0.550. We thus conclude that information provided by gray-scale and color Doppler US is useful in evaluating bowel wall thickening in ulcerative colitis.     

Expression of nitric oxide synthase in ulcerative colitis

Abstract. Nitric oxide (NO) is generated from L-arginine by a family of enzymes called the NO synthases. Previous investigators have proposed that the expression of this inducible enzyme (iNOS) may account for the characteristic vasodilatation, oedema and impairment of gut motility seen in active ulcerative colitis. Using a specific antibody to iNOS, we have investigated the distribution of this enzyme in colonic tissue from patients with histologically proven ulcerative colitis. Eight patients with ulcerative colitis expressed calcium-independent citrulline activity (9.96±2.34 pmol citrulline mg^-1 protein min^-1) and showed immunoreactivity to the iNOS antibody within the inflammatory infiltrate of the lamina propria, and also within the cytoplasm of the epithelial cells lining the colon. Five age-matched controls showed no calcium-independent citrulline activity (0.2 ±0.08 pmol citrulline mg^-1 protein min^-1) and no immunoreaction to the antibody. We conclude that this enzyme is present in colonic tissue including the epithelium from patients with active colitis. Inhibition of this enzyme may provide a novel therapeutic option for patients with active ulcerative colitis.     

十二指肠球部溃疡CT表现

目的 观察十二指肠球部溃疡的CT表现。方法 回顾性分析经胃镜确诊的44例十二指肠球部溃疡（溃疡组）和51例无十二指肠球部溃疡患者（对照组）的上腹部平扫及增强CT，比较组间十二指肠球部肠壁厚度、肠壁强化程度[动脉期及门静脉期CT值与平扫CT值的差值（ΔCT_动脉期和ΔCT_门静脉期）]、强化方式、黏膜面CT表现及周围脂肪间隙改变，绘制差异有统计学意义的参数诊断溃疡的ROC曲线，计算其AUC，评价其诊断效能；计算溃疡组CT漏诊率。结果 溃疡组十二指肠球部肠壁厚度[（7.52±2.30）mm]大于对照组[（2.89±0.75）mm，t=12.76，P<0.01]，2组肠壁ΔCT_动脉期及ΔCT_门静脉期差异均无统计学意义（t=-0.27、0.80，P均>0.05）。溃疡组十二指肠球部肠壁分层样强化、黏膜面不规则及周围脂肪间隙模糊发生率高于对照组（χ²=56.12、65.94、45.71，P均<0.01）。根据十二指肠球部肠壁厚度、强化方式、粘膜面CT表现及周围脂肪间隙改变诊断溃疡的AUC分别为0.99、0.90、0.93及0.84。溃疡组CT漏诊36例，漏诊率81.82%（36/44）。结论 肠壁增厚、分层样强化、黏膜面不规则伴周围脂肪间隙模糊为十二指肠球部溃疡的典型CT表现，准确识别有利于降低漏诊率。     

脑星形胶质细胞瘤CT表现及与手术、病理对照研究

目的:通过分析脑星形胶质细胞瘤的CT表现与手术、病理分级间对应关系,探讨CT表现的病理基础。方法:报道82例脑星形胶质细胞瘤的CT、手术、病理分级对照资料,并将病理分级分为3组:良性组(Ⅰ~Ⅱ级)16例,交界组(Ⅱ级)31例,恶性组(Ⅱ~Ⅳ级)35例,对3组间肿瘤大小、密度、水肿、强化程度、钙化、出血、囊变坏死等CT表现进行对照研究。结果:肿瘤的大小、钙化、血供、边界情况3组间无显著性差异;而肿瘤密度、瘤周水肿、强化程度及类型、瘤内囊变坏死、肿瘤硬度等3组间或两组间(良性组与交界组合并为一组)则存在显著性或高度显著性差异,其中恶性组趋向于呈混杂密度、中?蛐重度混杂强化、中?蛐重度瘤周水肿、瘤内多见坏死囊变、肿瘤硬度偏软等特征,良性组则相反。结论:不同病理分级的脑星形胶质细胞瘤的CT表现各有其特点,可作为肿瘤分级提示性诊断的依据。     

MR imaging of ulcerative colitis

High-resolution magnetic resonance imaging (MRI) was used to study 16 resected rectosigmoid specimens of patients treated with total colectomy for severe ulcerative colitis (UC). Six normal colon specimens were also studied as a control group. Moreover, a parallel study of the pelvis of 24 patients with a proven diagnosis of UC was performed with the same MR system. Both in vitro and in vivo MRI findings [thickening and signal intensity (SI)] of the mural layers were qualitatively evaluated by two radiologists and compared with gross and microscopic aspects. In vitro results showed that MRI was able to identify all layers of the colonic wall. In particular in UC specimens, MRI identified thickening and the peculiar abnormal hyperintensity of the mucosal and submucosal layers on spin-echo (SE) T1-weighted images. In vivo results confirmed the high-signal intensity of the mucosal and submucosal layers. These findings were not observed in the control group in which the superficial layers appeared low in intensity on SE T1 images. Our preliminary experience suggests that MRI should be considered a new imaging modality for detecting UC colonic wall changes.