内镜结合病理检查在溃疡性结肠炎和克罗恩病鉴别诊断中的价值

目的评价内镜及病理检查在溃疡性结肠炎和克罗恩病鉴别诊断中的价值.方法回顾性分析161例溃疡性结肠炎和89例克罗恩病的临床资料,对其病变分布、内镜结果及病理检查进行了分析.结果克罗恩病好发于末段回肠、右半结肠及上消化道,而溃疡性结肠炎好发于直肠.克罗恩病的病理特征有非干酪样肉芽肿、裂隙样溃疡、淋巴细胞聚集、全层炎;溃疡性结肠炎的病理学特征有弥漫性或灶性黏膜炎症、隐窝脓肿、黏膜糜烂及溃疡.结论内镜结合病理检查在溃疡性结肠炎和克罗恩病鉴别诊断中起到决定性作用,尤其手术标本的病理检查对CD诊断价值较大.

Clinical value of endoscopy and histopathology in differentiation of ulcerative colitis and Crohn's disease

Objective To valuate the clinical value of endoscopy and histopathology in differentiation of ulcerative colitis and Crohn's disease.Methods Clinical data of 161 cases of ulcerative colitis and 89 cases of Crohn's disease were reviewed by analyzing the examination results of endoscopy and histopathology.Results Crohn's disease usually located in the distal of ileum, right hemi-colon and upper gastrointestinal tract, while ulcerative colitis usually located in rectum. The histological characteristic parameters of Crohn's disease were non-caseating granuloma, fissuring ulceration, lymphocyte infiltration and transmural inflammation.While the histological features of ulcerative colitis were diffused or focused inflammation, crypt abscess and mucosa erosion or ulceration.Conclusion Combination of endoscopic and histopathological examination are of considerable importance in differentiation of Ulcerative colitis and Crohn's disease. Especially the histological examination of surgical specimen is critical in the diagnosis of Crohn's disease.