老年人缺血性结肠炎的临床分析

CLINICAL FEATURES ON ISCHEMIC COLIT IS IN ELDERLY

目的总结老年人缺血性结肠炎的临床特点，探讨早期诊断方法。方法收集分析了１９７５年６月至２００１年８月经结肠镜发现、病理确诊的缺血性结肠炎３９例的相关临床资料，按年龄是否大于６０岁分为老年组２９例与非老年组１０例，进行对比分析，所有病例均在腹痛等症状出现后５天内行全结肠内镜及病理检查，大多于治疗后２周至２个月内复查结肠镜，部分病例取病变粘膜活检，观察其内镜下表现及临床特点。结果老年组与非老年组的临床主要表现均为腹痛、血便及腹泻等，本组病变多数位于左半结肠。老年组一过性炎症型者有２４例，狭窄型有４例，仅有１例坏疽型。而非老年组一过性炎症型者有９例，狭窄型有１例，无坏疽型者。两组的病理学表现无特异性。结论早期行结肠镜检及病理组织学检查是诊断老年人缺血性结肠炎的主要方法。

Objective The aim of this paper is to evaluate clinical and endoscopic characteristics of ischemic colitis(IC),in order to find a way for early diagn osis of IC.Methods Thirty -nine patients had been diagn osed IC by Huadong Hospital from June,1975to Dec,2000.These patients were divided into 2g roups.The elderly group(age≥60years)consisted of 29cases and the non -elderly group,10cases.Their records were retrie ved and the data analyzed for sex,age,chief clinical presentation,concomitant medical conditions,recent special drug ingestion,subsequent interventions a nd outcome.After the onset of symptoms,all of these patie nts underwent colonoscopy and biopsy within 5days,colonoscopic re-examination was performed within 2weeks to 2months a fter treatment.Results At the onset of disease,all 39cases p resented sudden left lower abdominal pain,hematochezia and diarrhea.Ischemic lesions were seen mostly at the left colon.The eld erly group comprised a spectrum including tran sient or reversibled colitis in 22cases,strictured colitis in 4cases an d gangrenous colitis in only 1case.While the non -elderly group comprised 9cases of transient colitis and 1case of strictured coliti s.Morphologic changes after IC varies with the dura tion and severity of the injury.Conclusions Colonoscopy with biopsy is considered to be the main way for diagnosis of IC.It sh ould be performed at the early stage o f onset of symptoms.