老年人结肠血管病变临床分析

目的总结老年人结肠血管病变的临床、结肠镜及病理组织学特点。方法对22例下消化道出血患者均行结肠镜检查,并对其临床特点、伴发基础疾病、结肠镜和病理组织学变化进行分析。结果缺血性结肠炎患者主要表现为突发腹痛和便血;结肠镜下显示病变呈节段性分布、黏膜糜烂和不规则溃疡;组织学上表现为黏膜糜烂、黏膜下出血、腺管破坏等。结肠毛细血管扩张症患者主要表现为贫血、无痛性便血;结肠镜下显示与周围黏膜界限清楚的红色、斑片状、蜘蛛状或向周围放射扩张的毛细血管丛,并见糜烂和新鲜出血。结论缺血性结肠炎和结肠毛细血管扩张症在临床表现和结肠镜表现上各有特点,在发病2d内行结肠镜检查,对正确诊断和鉴别诊断非常必要。

Clinical Analysis on Colonic Vascular Lesion in the Elderly

Objective To sum up the features of clinic,colonoscope and pathological histology in the elderly patients with colonic vascular lesion.Methods 22 patients with hemorrhage of lower digestive tract were diagnosed by colonoscope,and the clinical features,basic deseases,colonoscope and pathological histology were analyzed.Results Most patients with ischemic colitis complained of sudden onset of abdominal pain and hematochezia;colonoscopy showed the lesions were always segmental in distribution;mucosal erosions and irregular ulcerations were observed;pathological findings such as mucosal necrosis,erosions and submucosal hemorrhage and glandular destruction were seen.Most patients with telangiectasis complained of painless hematochezia,anemia;colonoscopy showed red well-defined,macular or spider-like mucosal telangiectasia with stellate projections,and mucosal erosions or fresh bleeding were also observed.Conclusion The clinical and endoscopic features of ischemic colitis and telangiectasis are different in the elderly patients,early colonoscopy,especially within 2 days from the clinical onset,is essential for the confirmed diagnosis and identification of the diseases.