溃疡性结肠炎及其并发症治疗方式的探讨

Investigation on the management of ulcerative colitis and its complications.

目的 探讨溃疡性结肠炎及其并发症的治疗方式。方法 回顾性分析 10 8例溃疡性结肠炎病人的临床资料。结果 轻、中型溃疡性结肠炎采用药物保留灌肠和口服药物治疗 ,缓解率达 88 9% ,但 73 1%的病例呈周期性发作。并发症的治疗包括 :息肉电凝摘除 ,结肠大部分切除、回肠造口 ,全结肠直肠切除、回肠造口 ,全结肠直肠切除、回肠贮袋肛管吻合 (IPAA)等术式。全组病例无严重并发症和死亡 ,效果良好。结论 轻、中型溃疡性结肠炎应以药物治疗为主 ,其并发症的治疗应采用外科治疗 ,全结肠切除、回肠造口术及结肠大部分切除、回肠造口术仍为较安全的手术方式 ,但亦给病人带来生活上的不便 。

Objective To investigate the management of ulcerative colitis and complications.Methods The clinical materials of 108 ulcerative colitis cases were analyzed retrospectively.Results The patients with ulcerative colitis of mild and medium types were treated by using enema and oral administration.Remission rate reached 88\^9%.But periodical recurrence occurred in 73\^1% cases.The management of complications included polypectomy,subtotal colectomy with ileostomy and total proctocolectomy with permanent ileostomy,and restorative proctocolectomy with J pouch ileoanal anastomosis,etc.There were no severe complications and death occurred postoperatively.Effects of the treatment were good.Conclusion It is recommended that ulcerative colitis of mild and medium types should be treated by using enema and oral administration.Surgical management should be adopted to treat complications.Subtotal colectomy with ileostomy and total proctocolectomy with permanent ileostomy are safe and effective.But it is inconvenient in life to undergo the procedure.Therefore restorative proctocolectomy with J pouch ileoanal anastomosis is very welcome.