缺血性结肠炎的临床特点和转归

Clinical features and outcome of ischemic colitis

目的:总结缺血性结肠炎的临床特点和转归。方法:对64例缺血性结肠炎患者的临床特点、实验室及内镜检查、病理资料进行回顾性分析。结果:本病多发生于50岁以上中老年人(48/64,75.0%),女性多见(男∶女约为1∶2);伴有相关基础疾病者53例(82.8%),包括心脑血管疾病、糖尿病、血液病、风湿免疫病或腹腔手术史;主要表现为腹痛(61/64,95.3%)及便血(55/64,85.9%);早期内镜表现主要为结肠黏膜高度水肿、充血、出血、糜烂及溃疡;病变大多为一过型,如能早期诊断与治疗,多数转归良好。结论:中老年患者出现急性腹痛和便血应警惕缺血性结肠炎,结肠镜检查是早期诊断缺血性结肠炎的主要方法。

Objective： To summerize clinical features and outcome of ischemic colitis. Methods. Retrospectively analyzed data of 64 cases with ischemic colitis, including clinic feature, result of laboratory and endoscopy examination and pathological data. Results.. Out of 64 cases, 75.0% were over 50 years. Ratio of male and female was 1 ： 2. 82.8%were associated with basal diseases such as cardio-cerebrovascular disorders, diabetes and hematological diseases as well as the history of abdominal operation. Clinical manifestations were abdominal pain （ 61/64,95.3% ） and bloody stool （ 55/64,85.9 % ）. Earlier colonoscopy showed mucosal edema, congestion, erosion and ulceration. Most of cases were cured or improved after treatment. The earlier the diagnosis and treatment, the better the result and prognosis. Conclusion： Colonoscopy plays a vital role in the early diagnosis of ischemic colitis.