成都市55例克罗恩病临床病理分析

Clinical pathologic analyses of 55 cases of Corhn's disease in Chengdu

目的了解克罗恩病（Crohn’sDisease．CD）在成都市的发病情况及临床病理特点。方法对成都市三家医院确诊的55例CD进行回顾性分析。结果（1）住院病例数逐年增加，但其住院构成比仍低。（2）回结肠受累最多（61．8％）；腹痛（92．7％）为最主要临床表现；肠梗阻（45．5％）为最常见并发症。（3）肉芽肿检出率在手术标本为60％，活检标本为28．6％；（4）术前CD正确诊断率为29.1％，70．9％的病例被误诊，其中误诊为肠结核的最多（47．3％）。结论（1）成都市CD住院病例数逐年递增，反映了该市CD发病率增加的一个侧面。（2）CD临床表现复杂多样，误诊率极高，应特别注意与肠结核鉴别。（3）CD没有绝对形态学指标，肉芽肿检出率不高，诊断不应过分强调肉芽肿的存在。

Objective To investigate the incidence and clinical pathologic features of Crohn'sdisease (CD) in Chengdu. Methods 55 cases of CD were analyzed retrospectively. Results Thenumber of inpatients with CD increased. The most common site of involvement was terminal ileumand proximal colon (61. 8% ). The principal symptom was abdominal pain (92. 7 % ). Bowel obstruc-tion was the most common complication of CD (45. 5% ). Granulomas could be found in 60% ofcolectomy specimens and 28. 6% of biopsies, respectively. Diagnostic accuracy of CD was only 29. 5 %before surgery. Conclusion The number of inpatients with CD increased from 1989 to 1998, partial-ly reflect the increase of incidence. The clinical features of CD are complicated , causing diagnostic dif-ficulties. The difference between CD and intestinal tuberculosis should be attention on. There are noabsolute diagnostic indications for CD, diagnosis of CD requires combination of clinical, endoscopic .radiographic and histopathologocal exams.