重型溃疡性结肠炎56例的临床特点与治疗

Study on clinical manifestations and treatment of severe ulcerative colitis,report of 56 cases

目的探讨重型溃疡性结肠炎(UC)的临床特点以及治疗转归。方法回顾性分析重型UC患者56例的临床资料。记录其临床表现及诊疗经过,对柳氮磺胺吡啶/5-氨基水杨酸、皮质激素、免疫抑制剂等药物疗效进行评价,并对手术病例进行分析。结果重型UC患者占此期间住院UC患者的34.8%(56/161),其中19.6%(11/56)伴肠道外表现;87.5%(49/56)为全结肠型病变,初发型、慢性持续型及慢性复发型分别占33.9%(19/56)、32.1%(18/56)和33.9%(19/56);45例(80.4%)重型UC经药物治疗缓解,7例(12.5%)最终手术治疗。结论对于重型UC,除积极系统的药物治疗外,应及时评估药物疗效,掌握手术时机。

Objective To evaluate the clinical characteristics of severe ulcerative colitis（UC） and to find the factors influencing treatment and outcome.Methods The clinical data of fifty six inpatients with severe UC during 2006 to 2010 were retrospectively reviewed and analyzed.These clinical data including onset,symptoms,signs,laboratory findings,endoscopic features,radiological and pathological findings as well as its clinical treatment.Patients with surgical treatment were also included in this study.Results Fifty six（34.8%） of 161 inpatients were suffered from severe ulcerative colitis,and 87.5%（49/56） of them had pancolitis.Patients with first onset,chronic persistence and chronic recurrent type were accounted for 33.9%（19/56）,32.1%（18/56） and 33.9%（19/56） respectively.Forty five cases（80.4%） could be relieved by drug therapy.Seven cases（12.5%） were progressed to take operation.Conclusion Most patients with severe UC respond well to medical treatment,but in some non-responding or corticosteroid depending individuals,surgical treatment should be considered after reasonable duration of medical treatment.