50例缺血性结肠炎患者的临床特点分析

目的探讨缺血性结肠炎(ischemic colitis,IC)的临床特点,提高对该病的认识,做到早诊断、早治疗。方法回顾性分析2013年1月至2019年6月在苏州大学附属第一医院确诊的50例IC住院患者的临床资料。结果50例IC患者年龄(63.14±9.83)岁,多见于50~70岁年龄段(70.0%),以女性居多(62.0%),50例中饮酒者占12.0%,吸烟者占10.0%。临床表现主要有便血(92.0%)、腹痛(92.0%),有时可见腹泻(18.0%)、呕吐(18.0%)、发热(10.0%)、便秘(6.0%);多伴有高血压(34.0%)、糖尿病(20.0%)、肾囊肿(10.0%)、脑血管疾病(10.0%)等基础疾病及口服降压药、降血糖药、激素等药物史,12例有腹部手术史,4例有结肠炎史,4例有肠息肉史;5例合并房颤,4例合并肺结核,3例合并肾上腺疾病,2例合并特发性血小板减少性紫癜,2例合并动脉粥样硬化。2例合并风湿性心脑病,2例合并慢性肾病,1例合并肝血管瘤,1例合并白癜风,1例合并甲亢,1例合并痛风,1例合并深静脉血栓。结肠镜下病变多呈节段性分布,多有充血、水肿、糜烂,树枝状血管影,也可有溃疡,附着黄白苔。所有患者经内科治疗好转出院,以其首次诊断为IC为起点,随访至今,共有3例复发。结论IC的症状呈多样性、非典型性,全面了解IC患者的高危因素及早期结肠镜和活检检查有助于早期识别IC。

Clinical characteristics of 50 patients with ischemic colitis

Objective To analyze the clinical characteristics of ischemic colitis(IC)for early diagnosis and treatment.Methods The clinical data of 50 inpatients with IC were analyzed retrospectively from Jan.2013 to Jun.2019 in the First Affiliated Hospital of Soochow University.Results The average age of the 50 patients with IC was(63.14±9.83)years old,which was mainly found in the 50-70 years old(70.0%),and the majority of them were women(62.0%).Among the 50 patients,alcohol drinkers accounted for 12.0%and smokers accounted for 10.0%.The main clinical manifestations were hematochezia(92.0%),abdominal pain(92.0%),sometimes diarrhea(18.0%),vomiting(18.0%),fever(10.0%)and constipation(6.0%).Most patients were accompanied by hypertension(34.0%),diabetes(20.0%),renal cyst(10.0%),cerebrovascular disease(10.0%)and other basic diseases,as well as a history of oral antihypertensive drugs,hypoglycemic drugs,hormones and other drugs.12 patients had a history of abdominal surgery.4 patients had a history of colitis and 4 patients had a history of intestinal polyps.5 patients had atrial fibrillation.4 patients had pulmonary tuberculosis.3 patients had adrenal diseases.2 patients had idiopathic thrombocytopenic purpura.2 patients had atherosclerosis.2 patients had rheumatic heart disease.2 patients had chronic kidney disease.1 patient had hepatic hemangioma.1 patient had leukoderma.1 patient had hyperthyroidism.1 patient had gout.1 patient had deep vein thrombosis.Under colonoscopy,the lesions were mainly segmental in distribution,with congestion,edema,erosion,dendtritic vascular shadow and ulceration,covered with yellow-white moss.All patients had been recovered after medical treatment.Since they were firstly diagnosed with ischemic colitis,3 patients had relapsed.Conclusion The symptoms of IC are various and atypical.So overall knowledge of high risk factors and early colonscopy and biopsy are helpful for the early recognition of IC.