急性缺血性结肠炎26例临床表现与内镜诊断

Clinical manifestation and endoscopic diagnosis of acute ischemic colitis:report of 26 cases

目的探讨急性缺血性结肠炎的临床特征及早期诊断方法,以期减少临床误诊。方法对本院收治的26例急性缺血性结肠炎患者的临床资料进行回顾性分析、总结。结果26例患者入院初步诊断准确率为38.5%;结肠镜检查成功率为100%,84.6%的患者病变部位位于脾曲及左半结肠。镜下表现的共同特征是黏膜明显充血、水肿、糜烂及脆性增加,接触易出血。病变肠段与正常肠段黏膜分界清晰。结论提高对缺血性结肠炎的认识,早期应用结肠镜检查可以提高缺血性结肠炎的正确诊断率。

Objective To study the clinical features and early diagnosis of acute ischemic colitis in order to reduce clinical misdiagnosis. Methods A retrospective analysis of 26 patients with acute ischemic colitis was made. Results The accuracy rate of primary diagnosis of acute ischemic colitis was only 38.5%. The success rate of colonoscopy was 100%. 84.6% of the diseased region was splenic flexure and left hemicolon. The endoscopic features of acute ischemic colitis were congestion, oedema, erosion, bleeding of colon mucosa. It was clear between infected colon mucosa and normal colon mucosa. Conclusion Clinician should improve the recognition of acute iscbemic colitis. The early use of colonoscopy could raise accuracy rate of early diagnosis of ischemic colitis.