重症溃疡性结肠炎的药物治疗

Drug Therapy of Severe Ulcerative Colitis

本文参照1993年全国慢性非感染性肠道疾病学术研讨会制定的溃疡性结肠炎的诊断标准,对北京协和医院1974年1月至1995年1月的溃疡性结肠炎住院病人共148例进行了分析,着重探讨了我院对重症溃疡性结肠炎的药物治疗经验。结果显示,21年间溃疡性结肠炎在内科消化病的年住院率呈上升趋势,重症患者占72.3％。其临床治疗方法仍以激素、水杨酸偶氮磺胺吡啶和免疫抑制剂为主要治疗药物。本病在我院内科治疗的临床缓解率达95.9％,其中重症的临床缓解率达95.3％。死亡率为6.08％。我们提出对溃疡性结肠炎的内科治疗应遵循尽早控制症状、维持缓解、预防复发、防治并发症和掌握手术时机的原则:并根据病变的范围、疾病的活动性和严重程度、病程、病人的全身情况,以前用药情况和有无并发症等进行综合治疗。

Aims: To explore the experience of drug therapy of severe ulcerative colitis (UC).Methods: A retrograde analysis was made in our study in the 148 in-patient cases of UC between January 1974 and January 1995 in PUMC hospital. Results and Conclusion: Corticosteroids, sulfasalazine (SASP) and immunosuppressive agents are still the mainstay of UC treatment. The clinical remission rate of severe UC in our hospital is up to 95.3%. Treatment principle to UC includes ① Obeying the rule of controlling symptoms as early as possible, maintaining clinical remission, preventing relapse and complication, and arranging operation adequately;② Medical treatment should be arranged individually for each patient.