239例肠道溃疡性病变的临床特点分析

目的增加对以肠道溃疡性病变为主要表现的疾病的认识,提高其诊断率。方法收集2017年~2019年在我院诊治的病例239例,对其病因、临床特点、内镜表现进行回顾性分析。结果以肠道溃疡性病变为主要表现的疾病病因分两大类,肿瘤性溃疡76例,约占31.8%,其中局限溃疡型大肠癌72例(30.1%)、胃肠粘膜相关性淋巴瘤4例(1.7%)。非肿瘤性溃疡150例,占62.8%,其中感染性疾病47例(19.7%)、非感染性疾病103例(43.1%)。感染性疾病中,急性感染者23例(9.6%),慢性感染者24例(10.1%)。非感染性疾病中,以溃疡性结肠炎最为常见,共62例(25.9%),其次为克罗恩病17例(7.1%)、缺血性肠病15例(6.3%)。另有13例肠道溃疡原因不明,约占5.4%。结论以肠道溃疡性病变为主要表现的疾病病因复杂,部分疾病的临床表现及内镜特征不典型,应重视其诊断与鉴别诊断。

The Clinical Characteristics of 239 Cases of Intestinal Ulcerative Lesions

Objective To better understand peptic diseases with intestinal ulcer as main manifestation and improve the diagnosis rate.Methods Totally 239 cases of peptic diseases with intestinal ulcer which diagnosed and treated in our hospital from 2017 to 2019 were analyzed retrospectively,including etiologic factors,clinical characteristics and endoscopic manifestations.Results There were 76 cases of tumor ulcer(31.8%),including 72 cases of local ulcerative colorectal cancer(30.1%)and 4 cases of gastrointestinal mucosa associated lymphoma(1.7%).There were 150 cases of non neoplastic ulcer(62.8%),including 47 cases of infectious diseases(19.7%)and 103 cases of non infectious diseases(43.1%).Among the infectious diseases,23 cases were acute(9.6%)and 24 cases were chronic(10.1%).Among the non infectious diseases,the most common diseases was ulcerative colitis(25.9%),followed by Crohn's disease in 17 cases(7.1%),ischemic bowel disease in 15 cases(6.3%).Another 13 cases(5.4%)of intestinal ulcer were unknown.Conclusion The etiologic factors of peptic diseases with intestinal ulcer as main manifestation are various and complex,the clinical and endoscopic features of some diseases are not typical.More attention needs to be paid to the diagnosis and differential diagnosis.