结肠黑变病临床观察

【目的】探讨结肠黑变病的临床诊断、病理特征和治疗。【方法】对2003—2006年结肠镜检出并经病理证实的31例结肠黑变病进行回顾性分析。【结果】31例结肠黑变病中，男性发病率高于女性，平均年龄66．8岁，临床表现以便秘为主。结肠镜下可见结肠黏膜有棕褐色或黑褐色色素沉着，呈颗粒状、网状或虎皮状。病理检查示，黏膜固有层间质中有吞噬棕褐色色素的巨噬细胞。【结论】结肠黑变病主要与便秘、滥用泻药有关，可能与结肠腺瘤有关。治疗应针对便秘原因，尽量使用促动力药、非蒽醌类泻剂或微生态制剂。对经常服用蒽醌类泻药的患者应定期行结肠镜检查，注意发现黑变病，同时警惕是否有癌变或息肉的存在。对已经确诊为黑变病的患者，定期的肠镜随访是非常必要的。对有息肉、肿瘤表现者，应及早进行积极治疗。

Clinical analysis on 31 cases of melanosis coli

Objective] To investigate the clinical diagnosis, pathology features and treatment of melanosis coli. Methods] The endoscopic and clinical of 31 cases with melanosis coli from 2003 - 2006 were retrospectively analyzed. Results] Among the 31 patients, the morbidity of the male cases is higher than the female ones. The averaged age of the 31 patients was 66. 8 years old. The main clinical manifestation of the patients is constipation. Culoscopy showed the there were brown or brown - and - black pigmentation on the colonic mucosa, and in shape of granule, reticulata or tiger fur - like; Pathological examination showed that in interstitial of lamina propria of mucosa there were phagoeytizing - brown pigment macrophages. Conclusions] Melanesis eoli is mostly related to constipation and abuse of laxatives, and it is probably connected with adenorna of colon. The therapy of melanesis eoli should be aimed at constipation. Aetuation strength rnedieine, non - anthraquinone laxative or mieroeeology preparation should be used. A time eolonoseopy should be performed on the patients who take medicine of anthraquinone laxative. Observations should be carried out carefully to find out melansis eoli. Polyps and carcinoma should be paid attention to. To the patients having been diagnosed of melanosis coli, periodical follow - up survey is necessary. To the patients having the perfonnance of polyps or carcinoma, the active rteament should be carried on at early as possible.