500例溃疡性结肠炎住院患者临床特征回顾分析

Retrospective analysis on clinical characteristics of 500 cases of inpatient with ulcerative colitis

目的回顾性调查500例溃疡性结肠炎(UC)住院患者的临床资料,分析UC的发病特征和诊治特点。方法采集2014年1月—2016年6月南京中医药大学附属医院脾胃病科确诊为UC住院患者的临床信息,对其基本信息、诊治情况进行回顾性分析。结果 500例患者中,男女之比为1.24∶1,中位年龄为42岁,平均病程4.5年。住院患者活动期458例(91.60%),缓解期42例(8.40%)。活动期患者以轻中度为主(77.07%),疾病类型以慢性复发型占多数(90.83%),病变范围为直肠95例(20.74%)、左半结肠166例(36.24%)、广泛结肠197例(43.01%)。500例患者腹泻发生率最高(74.20%),其次为腹痛(69.60%)和黏液脓血便(68.20%)。活动期患者中症状出现频率从高到低依次为腹泻(77.07%)、黏液脓血便(72.71%)和腹痛(70.09%)。此外44例(8.8%)患者有肠外表现。500例患者中,治疗主要以中西医结合为主,其中中药口服483例(96.60%),中药灌肠423例(84.60%);西医治疗包括氨基水杨酸类口服(91.20%)、氨基水杨酸类纳肛(30.40%),及微生态制剂(93.0%)、糖皮质激素(17.20%)、免疫抑制剂(2.0%)和抗生素(12.45%)口服等。多数患者经内科治疗好转出院,因保守治疗无效或效果不佳而手术治疗者2例。结论我院UC住院患者疾病类型以慢性复发型、轻中度为主,肠外表现及并发症较少,中西医结合治疗效果较好。

Objective The clinical data of 500cases of inpatients with ulcerative colitis (UC)were retrospectively investigated and the characteristics of pathogenesis and diagnosis of ulcerative colitis analyzed.Methods The clinical information of the patients with ulcerative colitis were collected from January 2014to June 2016,the basic information and the diagnosis situation were analyzed retrospectively.Results Among 500patients,the male-female ratio was 1.24:1,the median age was 42and the average course of the disease was 4.5years.There were 458patients (91.60%)in active and 42patients (8.40%)in remission period.Among the patients in active period,most of them were in mild or moderate(77.07%)situation;and the ehronie reeurrence was the majority(90.83%). The main sites of lesion were located at rectum in 95eases(20.74%),the left colon in 166cases(36.24%)and extensive colon in 197cases(43.01%).Among the clinical features,the rate of diarrhea was the highest(74.20%),the second was abdominal pain (69.60%)and bloody mucopurulent stool(68.20%).In the active period,the frequency of these symptoms was diarrhea(77.07%), bloody mueopun^ent stool(72.71%)and abdominal pain (70.09%).In addition,44patients (8.8%)had parenteral manifestations. Treatment drugs mainly focus on the combination of traditional Chinese and Western medicine.Among them,herbal medieine were taken orally in 483cases (96.60%),Chinese medicine enema were used in 423cases (84.60%).Western medicine treatment included oral amino salicylate drugs (91.20%),external use of it (30.40%),probioties (93.0%),glueocortieoids (17.20%), e agents(2.0%)and antibiotics(12.45%).Most of the patients were discharged from internal medicine,and 2 eases were treated with operative treatment after ineffectiveness and unsatisfactory result.Conclusions In the past two years, hospitalized patients in our hospital mainly belong to chronic recurrent types in the mild and moderate condition.There are fewer parenteral manifestations and complications and the effect of combination of Chinese and western medicine is better.