白塞综合征合并肠外瘘的诊治

目的：探讨白塞综合征合并肠外瘘的诊治。方法：对1例2次手术后均合并肠瘘的白塞综合征患者行回盲部、末端回肠切除并回肠造瘘术的资料进行总结。结果：患者术后未再出现肠瘘,恢复良好。待二期手术。结论：白塞综合征合并肠外瘘应进行以手术为主的综合治疗。     

白塞综合征合并静脉栓塞10例分析

目的　探讨白塞综合征合并静脉栓塞的临床特点。方法　回顾性分析 10例白塞综合征并静脉栓塞患者的临床资料。结果　白塞综合征患者下肢静脉血栓较上肢多见 ,以中等以上静脉阻塞为主 ,治疗以足量的激素及免疫抑制剂联合应用 ,免疫抑制剂一般首选环磷酰胺 ,本组 10例显效 8例 ,有效 2例。结论　对于静脉血栓患者临床除了考虑其它系统性疾病外 ,应想到白塞综合征。     

肠外瘘23例诊治体会

<正> 肠外瘘是腹部手术后较常见的严重并发症,一旦肠外瘘发生目前主要采取积极的综合治疗措施而达到治愈目的。1982年10月至1997年12月我们对23例肠外瘘进行了积极的综合治疗,现将诊治体会报告如下。     

白塞综合征长期误诊1例

白塞综合征系一少见原因不明,以复发性口腔、外生殖器溃疡及眼部炎症为特征的自体免疫性疾病。我所收治1例典型的白塞综合征,曾在多家医院就诊,被误诊为“化脓性扁桃腺炎”,误诊时间长达6～7年。患者,男性,41岁,工人。主诉:扁桃体切除术后发热6天,加重3天。患者于6～7年前经常发热,近一年来周期性发热,约每月一次,每次体温均高达39℃以上,继之出现扁桃体化脓,白细胞明显增高及关节疼痛。两个月前再次出现上述症状及“OT”试验强阳性,抗“O”1:800     

白塞综合征1例护理体会

报道1例白塞综合征患者的护理。通过护理病例讨论的形式制定了完整的护理计划和护理措施,实施了有效的全面的综合护理,取得良好效果。     

白塞综合征的护理

白塞病是一种自身免疫病，是由多病因引起的以血管炎为病理基础的全身性自身免疫病变。病变反复发作，病程漫长，容易复发，难以根治。一般好发于青年，临床表现为口腔溃疡、眼部损害视力下降、眼睛疼痛、外阴部溃疡、皮肤损害的多系统病变，俗称眼、口生殖器三联症。     

白塞综合征合并急性格林巴利综合征1例

A 40-year-old male patient was referred to our department with complains of recurrent oral ulcer for more than 20 years and vulvar ulcer for more than 10 years. He presented with a 3-month history of right external ophthalmoplegia. More than 10 days ago, the patient received ganglioside infusion. And one week ago, he developed numbness and pain of his lambs, and progressive myasthenia, accompanied by right blepharoptosis and dysuria. On exam, motor strength was graded 0/5 in the lower and the upper extremities. Deep tendon reflexes were diminished in extremities. His admission medical examination: hemoglobin (HGB), white cell and platelet counts were normal. C-reactive protein (CRP) was negative. Erythrocyte sedimentation rate (ESR) 53 mm/h. Antinuclear antibody (ANA), anti-dsDNA antibody, anti-Smith antibody, anti-cardiolipin antibody and human leucocyte antigen B51 were all within normal range. The etiological tests of influenza A pathogen, influenza B pathogen, parainfluenza virus, enterovirus and parvovirus were all negative. He tested positive for serum anti-GM1 IgG. Cerebrospinal fluid had a normal white cell count, an elevated protein content. Gram staining, culture and PCR detection for varicella-zoster virus, cytomegalovirus and herpes simplex virus were all negative. Antibodies associated with autoimmune encephalitis and paraneoplastic syndrome were negative in cerebrospinal fluid. Electromyography and nerve conduction studies showed a severe axonal damage affecting motor nerves. No obvious abnormalities were observed in his magnetic resonance imaging of brain and cavernous sinus. The patient was diagnosed with Behcet syndrome complicated with acute Guillain-Barré syndrome. He received intravenous methylprednisolone, intravenous immunoglobulin (IVIg) therapy, plasma exchange and rituximab treatment. After treatment, the patient’s muscle strength of limbs was restored to grade 1, blepharoptosis and pain disappeared. The nervous system involvement of Behcet syndrome is relatively rare, especially combined with Guillain-Barré syndrome, which is easy to cause misdiagnosis. The treatment of Behcet syndrome complicated with acute Guillain-Barré syndrome includes the treatment of primary disease, plasma exchange and IVIg therapy. In addition, supportive treatment is very important for such patients. The focus of treatment is to avoid respiratory insufficiency, prevent deep vein thrombosis, monitor cardiac function and hemodynamics. Pain-relieving, physical exercise and psychological support are often under-recognized. The rehabilitation treatment is very important to improve the prognosis and quality of life of patients. What we need to learn is that when the symptoms and signs of the nervous system are difficult to be explained by neuro-Behcet syndrome alone, we should be alert to the possibility of other nervous system diseases.     

白塞综合征32例临床分析

白塞综合征是一种以反复发作的口腔、外生殖器溃疡及眼综合征为特征，累及多系统、多器官的血管炎症性疾患。本文收集我院1997-01～2004-05白塞综合征住院病人32例，现将临床资料进行分析，报道如下。     

肠外瘘34例临床分析

目的 探讨导致肠外瘘发生的危险因素。预防及治疗措施。方法 对1991年1月-2002年1月本院收治的肠外瘘34例临床资料进行回顾性分析。结果 34例患者自愈11例，手术治愈18例，死亡5例，死于感染和其他脏器衰竭。结论 肠外瘘预防的重点是围手术期的合理处理和正确的手术操作。对血流动力学不稳定及严重感染的患者，应简化操作，不强行肠管切除和吻合，治疗以控制感染为主。同时给予合理的营养支持，加强监测，争取自愈，若无自愈的可能，则考虑手术。对于发生较早的肠瘘可选择性地早期手术。     

调经养血治疗白塞综合征1例

女，39yr，初诊2002-08-15。每次经期前后发热，伴口腔、外阴部溃疡，反复发作已6a。现月经将行，腹痛腰酸，脉弦细，苔糙腻，大便1-2d 1行。中医辨证属“狐惑”，血分有热，肠胃消化不良。西医诊断：白塞综合征。治拟调经养血、和中安神、解毒化湿。处方：党参12g，当归10g，生地30g，赤芍12g，怀牛膝10g，龙胆草5g，丹皮参（各）15g，广木香5g，鲜石斛2g，川断12g，蛇床子12g，狗脊12g，香附6g，生滑石30g（先下）。14贴。     

肠外瘘36例临床分析

肠外瘘３６例临床分析栾维盈李志方１９７７～１９９２年，我们对３６例肠外瘘病人进行了治疗，现报告如下。１临床资料１．１一般资料肠外瘘病人３６例，男３０例，女６例；年龄１３～７９岁，平均３５．７岁。其中小肠高位瘘１８例，低位瘘１２例，结肠瘘６例。发生于原...     

白塞综合征外阴溃疡7例报道

目的 探讨白塞综合征外阴溃疡临床特点及诊治策略.方法 回顾性分析2004年9月至2009年9月就诊的7例白塞综合征外阴溃疡患者的临床资料.结果 7例患者均经临床诊断为白塞综合征外阴溃疡,男1例,女6例,平均年龄为(28.71±3.55)岁.治疗方法为口服泼尼松+局部外用药.2例女性患者于溃疡痊愈后6个月内复发,2例失访,3例随访2～5年(中位时间3.5年)未复发.结论 白塞综合征外阴溃疡病程进展较快,发病年龄较为年轻,复发率较高,口服糖皮质激素+局部外用药能控制病情,局部外用药喷涂的效果仍需进一步探讨.     

白塞综合征的结肠病变(附2例报告)

本文报告了两例白塞综合征(以下简称BS)的结肠病变。两例皆为女性。一例为教师,45岁;另一例是工人,19岁。均因右下腹包块入院,均有七年以上BS病史,均具备诊断BS的三个主要标准,都经常有轻度腹痛及粘液便等症状。体检:其右下腹部均可触及包块,界限清,有活动性。X线检查见盲肠或部分升结肠均有缺损区及粘膜破坏。均行右半结肠切除术并获痊愈。切除标本病理检查为非特异性炎症,符合BS改变。     

低位肠外瘘治疗体会

肠外瘘是腹部外科常见，而严重的并发症。低位肠外痃处理合理、及时，则恢复顺利，愈后效果好。现将我院1990年1月～2005年1月，15年间发生的15例低位肠瘘治疗惰况报告如下。     

白塞综合征29例临床探讨

目的 总结白塞综合征（BS）的临床特点及诊疗体会。方法 对29例BS的临床资料进行回顾性分析。结果 29例BS除常见口腔，生殖器溃疡外，皮肤关节损害为主要表现。心脏损害16例，占55.2%，其中主动脉瓣关闭不全9例，同时合并二尖瓣关闭不全7例；眼损害占20.68%，治愈26例；死亡3例，均有严重心瓣膜损害的心脏白塞病（CBD）患，结论 本组BS以心脏损害为主要特点，CBD多侵犯主动脉瓣及二尖瓣，CBD的预后不佳。     

114例白塞综合征的临床资料回顾性分析

目的：探讨白塞综合征的临床特点、实验室检查以及药物治疗,提高对该病的认识,更好的为临床诊疗工作提供参考,从而更加有效的进行对此病的治疗。方法：收集了新疆医科大学第一附属医院2009年1月~2013年6月期间就诊于口腔颌面外科、风湿免疫科及皮肤科病房诊治的白塞综合征患者。对发病年龄、性别、临床表现、实验室检查、治疗方案及疗效等项目列表登记,应用统计学方法得出相关结论。结果：本组资料患者共114例,男性52例（45.61%）,女性62例（54.39%）,各年龄段均可发病,发病年龄不存在性别差异（P〉0.05）。症状按发生频率由高到低排列为：口腔溃疡114例（100%）,皮肤损害76例（66.67%）,生殖器溃疡20例（17.54%）,发热25例（21.93%）,统计分析后均不存在性别差异（P〉0.05）。汉族与维吾尔族的发病类型存在差异（P〈0.05）;针刺反应阳性51例（44.74%）,统计分析后存在性别差异（P〈0.05）。常规实验室检查异常指标中：白细胞计数增加、红细胞沉降率增快存在明显性别差异。沙利度胺联合泼尼松治与免疫抑制剂联合泼尼松治疗白塞综合征效果明显优越与单一使用泼尼松。结论：白塞综合征各年龄均可发病,临床表现多样,针刺反应阳性存在显著性别性差异,民族之间不同类型存在差异,联合用药治疗效果明显优于单一用药。     

白塞综合征的呼吸系表现(附34例分析)

本文报告了34例白塞综合征的呼吸系表现,其总发生率约为35.3％。主要症状有咳嗽、咯血、呼吸困难及胸痛等。其肺损害表现为:①肺片状浸润形;②胸膜炎性改变;③间质性肺炎;④肺门淋巴结肿大;⑤肺纹理增强、紊乱及肺间质纤维化等。并探讨了该病引起肺损害的原因及诊治问题。     

α干扰素在白塞综合征中的应用进展

Behcet syndrome (BS) is a chronic systemic inflammatory disorder involving vessels of all sizes, characterized by relapsing episodes of oral and/or genital ulcers, as well as skin lesions. Ocular, vascular, gastrointestinal, neurological system involvement can cause significant morbidity and mortality. Glucocorticoids and immunosuppressants are the cornerstones for the management of BS. Biologic agents has been recommended for severe and/or refractory BS. Interferon-α (IFN-α) had multiple biological effects, such as antiviral and antiproliferative, that could regulate both innate and adaptive immunity in BS. Growing evidence showed the efficacy of IFN-α in severe and/or refractory BS. Many studies have demonstrated that IFN-α has comparable effectiveness and tolerance profiles as anti-tumor necrosis factor (TNF) agents for Behcet’s uveitis with a much lower cost and steroid-and immunosuppressant-sparing effects. IFN-α has been recommended as second-line therapy for ocular involvement of BS in EULAR (The European League Against Rheumatism) 2018. IFN-α also improves mucocutaneous lesions in BS with the dosage from 3 to 9-12 million IU three times per week. A few cases indicated the therapeutic potential of IFN-α in intestinal BS. As a new trial of IFN-α in vascular BS (VBS), a recent study revealed the lower relapse rate and higher recanalization rate with IFN-α in lower extremity deep vein thrombosis (DVT). Another two case reports presented the efficacy of IFN-α in pulmonary artery involvement in BS. Also, case reports have shown successful treatment in refractory neurological involvement. There are two subtypes of IFN-α commonly used in autoimmune diseases, named IFN-α2a and IFN-α2b. IFN-α2a seemed more effective than IFN-α2b, especially in ocular and mucocutaneous involvement of BS. Side effects of IFN-α are dose-dependent and not severe. The most frequent side effects are flu-like syndrome, mild leukopenia and alopecia. Considering the potential risk of tuberculosis (TB) and hepatitis B virus (HBV) reactivation of TNF-α inhibitors, IFN-α is safe due to its anti-HBV effect and protective effect on TB. In conclusion, IFN-α is a promising choice for severe and/or refractory BS patients, especially for those who are intolerant or contraindicant to other biological agents, such as TNF inhibitors. Further prospective controlled studies are warranted to confirm the efficacy and safety of IFN-α in BS.     

辨证治疗白塞综合征138例临床观察

白塞综合征是以眼、口腔、生殖器和皮肤溃疡症状为主的综合征,又称眼、口、生殖器综合征,我们2005--2009年应用中医药辨证治疗自塞综合征138例,效果满意,报告如下。