中老年人缺血性结肠炎19例临床分析

目的总结中老年缺血性结肠炎（IC）的临床特点，提高诊治水平。方法回顾性分析2005～2011年19例Ic患者的临床症状、体征、相关基础病、内镜表现及病理资料。结果该病多发生于50岁以上中老年人，男：女为0．58：1，且多数患者（89．47％）伴有心脑血管疾病、高脂血症、糖尿病、便秘及腹部手术史。临床表现均有不同程度的腹痛（100．oo％）、腹痛后便血（100．00％），多数伴有腹泻。结肠镜检查示，病变部位以左半结肠为主（94．74％），表现为黏膜纵行充血、水肿、糜烂、溃疡及黏膜下出血，病变黏膜与正常黏膜分界清楚。一过型16例，狭窄型2例，坏疽型1例。结论对有动脉粥样硬化等易患因素的中老年人，如发生急性腹痛、便血等症状，均应考虑Ic的可能，及时行内镜检查，密切观察，早期诊断、治疗，提高诊断率和治愈率。

Clinical analysis of 19 middle-aged and older patients with ischemic colitis

Objective To summarize the clinical features of middle-aged and older patients with ischemic colitis（IC）, and elevate the level of diagnosis and treatment. Methods A retrospective analysis was performed of 19 patients with of IC from 2005 to 2001, including the clinical symptoms, signs, the basic disease, endoscopic findings and pathological data. Results This disease was mainly seen in the elderly patients aged over 50 years（male：female was 0. 58：1 ）, and the majority of patients （89. 47% ） were complicated by cardiovascular diseases, hyperlipemia, diabetes, constipation and abdominal operation history. Clinical manifestations included the different levels of abdom- inal pain（ 100. 00% ）. hematochezia after abdominal pain（ 100.00% ）, most accompanied by diarrhea. Colonoscopy showed, the site of lesion was mainly seen in left colon（94. 74% ）, mainly manifested as longitudinal mucosal hyper- emia, edema, erosions, ulcers and submucosal bleeding, clear demarcation between lesion mucosa and normal muco- sa ;transient and reversilde type was found in 16 cases, nattow type in 2 cases, gangrene in I case. Conclusion The middle-aged and older patients with the atnerosclerosis risk factors, when acute abdominal pain, bloody stool and oth- er symptoms occurred, should be suspected of suffering from IC. For these patients, endoscopy should be performed promptly and closely observed in order to early diagnose ,early treat and to improve the diagnosis rate and cure rate.