缺血性结肠炎43例临床分析

Clinical and endoscopic characteristics of 43 cases of ischemic colitis

目的探讨缺血性结肠炎的临床表现、内镜特征及诊治方法。方法回顾性分析43例缺血性结肠炎患者的临床资料。结果缺血性结肠炎多发于60岁以上中老年女性患者,尤其伴有糖尿病以及心、脑血管等基础疾病者。腹痛、腹泻及便血为主要临床表现。结肠镜下以黏膜充血、水肿、糜烂、溃疡等为主要表现,病变主要见于左半结肠,呈节段性分布,病变与正常黏膜分界清楚,多数患者预后良好。结论中老年人(尤其合并有心脑血管及糖尿病等疾病者)出现不明原因的腹痛、腹泻、便血者应考虑缺血性结肠炎可能,应尽早行结肠镜检查,必要时行血管造影或其他影像学检查。此外,结肠镜检查过程中有诱发缺血性结肠炎的可能。

Objective To analyze the clinical and endoscopic characteristics, diagnosis and treatment of ischemic colitis. Methods 43 cases of schemic colitis were retrospectively analyzed including clinical characteristics, diagnosis and treatment. Results Ischemic colitis occurred more often in elderly patients （over than 60 years） , and had concom- itant basic diseases, such as diabetes, hypertension, coronary heart disease and cerebrovascular diseases. The main characteristics of ischemic colitis were abdominal pain, diarrhea and hematochezia. The pathological changes included mueosal edema, congestion, erosion and ulceration, and the lesions mainly located in the left colon and distributed in a segmental pattern by colonoscopy, and the majority of patients prognosis was good fortune. Conclusion When the eld- erly person, especially merger cardiaccerebral vascular disease, appear unexplained abdominal pain, diarrhea, bloody stools, we should consider ischemic colitis possible, and as soon as possible under go colonoscopy, make necessary angiography or other imaging examination. In addition, colonoscopy operative in the process can induce ischemic colitis.