结肠镜检查在缺血性结肠炎诊断中的价值

The Value of Colonoscopy in the Diagnosis of Ischemic Colitis

目的探讨结肠镜检查在缺血性结肠炎诊断中的价值。方法回顾性分析2009年1月至2013年12月经结肠镜检查确诊缺血性结肠炎30例患者的临床及内镜资料,所有患者均在发病后72h内行结肠镜检查,同时在病变部位取黏膜组织行病理检查。结果临床主要表现为腹痛、便血,80%患者病变部位位于左半结肠,内镜下表现为不同程度的充血水肿、糜烂及纵行溃疡,呈节段性分布,与正常黏膜界限清楚。10例患者行腹部CT检查,8例提示结肠节段性炎症改变;病理学检查无特异性。结论早期行结肠镜检查是诊断缺血性结肠炎的主要方法,CT适用于缺血性结肠炎的初步筛查。

Objective To evaluate the value of colonoscopy in the diagnosis of ischemic colitis. Methods The clinic data of 30 patients diagnosed ischemic colitis from January 2009 to December 2013 were retrospectively reviewed. Results The clinical features of ischemic colitis were abdominal pain and hematochezia. Colonoscopic visualization of ischemic colitis included segmental erythema、erosion and longitudinal ulceration. The lesions were mainly located at left colon with segmenta1 form （80% , 24 / 30）. Abdomen CT was performed in 10 patients, and segmental colon wall thickening was observed in 8 patients. Nonspecific inflammatory changes were identified in the biopsy. Conclusion Early colonoscopy plays an important role in the diagnosis of ischemic colitis, and CT can be given as a screening procedure when diagnosis of ischemic colitis is suspected.