溃疡性结肠炎的并发症

溃疡性结肠炎是慢性复发性疾病,其并发症直接影响该病的预后。本文以1993年全国慢性非感染肠道疾病学术研讨对本病会制定的诊断标准,对北京协和医院1974年1月至1995年1月溃疡性结肠炎住院和门诊病人483例进行了分析,着重探讨并发症的种类与疾病严重程度的关系以及对预后的影响。本组病人并发症的发生率为6.2％(30/483)。重症患者并发症的发生率为24.3％。并发症的种类,按其发生频率的多少依次排列如下:严重电解质紊乱(9.01％)、肠梗阻(8.11％)、人出血、菌群失调,肠穿孔(各3.60％)、败血症(2.70％)、肠瘘、癌变(各1.80％).中毒性肠扩张(0.90％)。本组溃疡性结肠炎早期并发症,除电解质紊乱外尚有大出血、中毒性肠扩张、败血症多见,随病程迁延则以肠梗阻、肠瘘、肠穿孔和癌变为主。并发症多发生于重度活动期(24.3％);其中病变累及全结肠为82％,左半结肠仅为18％。住院病人中该病病死率为6.08％,并发症组为23.08％,高于无并发症组(2％)。因此,对溃疡性结肠炎的并发症,要提请广大临床医师注意:需早期诊断,积极治疗,以减少病死率。

Complications of Ulcerative Colitis

Aims: To explore the relationship between the complications of ulcerative colitis (UC) and its severity or prognosis. Method: A retrograde analysis was made in 483 (out- and in-patient) cases of UC between January 1974 and January 1995 in PUMC hospital. Results: The incidence of complications of UC is 6.2% (30/483). The incidence of complications of severe UC is 24.3%. The frequencies of complications are successively as the follows: severe electrolyte imbalance (9.01%), colonic obstruction (8.11%), massive colonic hemorrhage (3.6%), colonic perforation (3.6%), septicemia (2.7%), colonic fistula (1.8%), carcinoma of the colon (1.8%), toxic megacolon (0.9%). Severe electrolyte imbalance, massive colonic hemorrhage, septicemia and toxic megacolon usually occurred at the early stage of UC. Whereas colonic obstruction, colonic fistula, perforation and carcinogenesis were usually seen at the late stage of UC. All of those complications were associated with severe UC. The entire colon was involved in about 82%, left colon involved in 18%. The mortality rate of UC of in-patient was 6.08%. The mortality rate of UC with complications (23.08%) is significantly higher than that without complications (2%).