32例缺血性结肠炎的临床分析

Clinical analysis of32patients with ischemic colitis

目的 :探讨缺血性结肠炎的临床表现、内镜特点。方法 :病例均于症状出现后1～14天内行全结肠内镜检查 ,并于首次检查后两周至四个月内进行结肠镜复查 ,部分病例取病变粘膜活检 ,观察其临床特征及内镜下表现特点。结果 :32例缺血性结肠炎中 ,男12例 ,女20例 ,平均年龄53 7岁 ,高峰年龄为61～70岁组。20例患有动脉硬化相关性疾病 ,6例无可以证明的基础病变 ,但其中的4例有便秘史 ,大部分为一过性炎症型者。临床表现主要为腹痛、血便及腹泻 ,少数患者有呕吐或恶心。内镜下表现多样化 ,病变粘膜与正常粘膜界限清楚 ,多数病变位于左半结肠 ,无直肠病变。病理表现无特异性。结论 :缺血性结肠炎可以发生于各个年龄组 ,但以中年以上发病率为高 ,发病部位多位于血流相对不足的左半结肠 ,并易发生纤维狭窄。血管因素与肠管因素为致病的重要原因。

Objective:To understand the symptoms,colonscopic features and pathogenesis of the ischemic colitis.Methods:The colonoscopy was performed for all patients with ischemic colitis in1to14days after the symptom onset,and followed up in2weeks to4months after the first time of colonoscopy,excluding antibiotics used within2weeks.Results:The ischemic colitis was diagnosed by colonoscopy in32patients,in which12cases were male and20female,aged36to79years with a mean age of53years.6of32patients were under40years of age,peak age was between61and70years of age.20suffered from arteriosclerosis associated with this disease.6were healthy,but4of them had the history of constipation.Endoscopic findings were diversify,including bloody and edematous mucosal necrosis and linear ulceration,the lesions had clear margin with normal mucosa.Most of lesions were seen at left colon.Conclusion:The ischemic colitis may develop at any age group,but its morˉbidity is higher in elder patients with arterio sclerosis associated with this disease.