缺血性结肠炎与细菌性痢疾的临床特征分析

Analysis of the clinical characteristics of ischemic colitis and bacillary dysentery

目的:探讨缺血性结肠炎(ischemic colitis,IC)与细菌性痢疾临床特点及内镜下表现的异同,以提高IC的临床诊治水平。方法:采用回顾性分析的方法,收集29例IC患者与20例细菌性痢疾患者的一般情况、临床症状、相关的基础疾病、内镜下表现、大便培养,并进行比较分析。结果:29例IC患者与20例细菌性痢疾患者的平均年龄、相关的基础疾病、腹痛的特点及病变部位相比较均有统计学意义(P均<0.05);29例IC患者大便培养均未见致病菌,细菌性痢疾患者均培养出致病菌。结论:有相关基础疾病的老年患者出现腹痛后便血症状时,提示IC可能性大,早期的结肠镜检查与大便培养检查是IC与细菌性痢疾的主要鉴别方法。

Objective To compare the clinical features and endoscopic features between ischemic colitis（IC） and bacillary dysentery.Methods The general condition,clinical symptoms,physical signs,underlying diseases,colonoscopic features,coproculture of 29 patients with IC and 20 patients with bacillary dysentery were retrospectively analyzed and compared.Results There were significant differences of the ages,underlying diseases,characteristics of abdominal pain and the lesion site between the two groups（all P 0.05）.The coproculture results showed that no pathogenic bacteria was found in 29 patients with IC,while pathogenic bacteria could be found in all 20 patients with bacillary dysentery.Conclusions IC should be suspected in elderly patients,who had related underlying diseases,suffered hematochezia after abdominal pain.The early endoscopy and coproculture were the main method for differentiating IC and bacillary dysentery.