非特异性回肠末端溃疡的临床随访分析

A follow-up analysis of the recurrence of nonspecific terminal ileum ulcer and the risk factors

目的分析非特异性回肠末端溃疡的转归及影响因素。方法分析我院6年来发现的175例回肠末端溃疡病例的临床、内镜及病理资料,随访观察85例非特异性回肠末端溃疡患者。结果 85例非特异性回肠末端溃疡患者临床表现为轻度胃肠道症状,包括慢性腹泻和/或腹部疼痛/不适;溃疡多表现为多发、表浅和小（3-6 mm）,病理表现为非特异性炎症。无论用药与否未发现患者症状加重,χ^2分析显示用和不用药物对非特异性小肠溃疡症状疗效无影响（P〉0.05）;随访42例发现腹痛、腹泻、饮酒是影响非特异性小肠溃疡愈合的重要因素,logistic分析显示呈显著负相关（P〈0.05）。有2例腹痛腹泻症状持续患者最后诊断为克罗恩病（Crohn＇s Disease,CD）。结论非特异性回肠末端溃疡大多为非特异性慢性炎症反应,病因不明,预后良好,临床可随访观察,腹痛、腹泻、饮酒是影响非特异性小肠溃疡愈合的重要因素。

Objective To examine the factors that contribute to the recurrence of nonspecific terminal ileum ulcer. Method The clinical,endoscopic and pathological data of 175 cases of terminal ileum ulcer observed in our hospital over the past 6years were examined,and 85 cases of non specific terminal ileum ulcer were followed up. Findings The clinical symptoms of the 85 patients with non specific terminal ileum ulcer were mild gastrointestinal symptoms,including chronic diarrhea and / or abdominal pain / discomfort. The ulcer was multiple,superficial and small（ 3 - 6mm）,and the pathological features were nonspecific inflammation. No worsened symptoms were identified either with or without medicine used. χ^2 analysis also showed that the medicine had no effect on the symptoms of non-specific small intestinal ulcers（ P〉0. 05）. 42 cases follow-up of 42 cases indicated that abdominal pain,diarrhea and alcohol consumption were the leading factors affecting the healing of the ulcers and they were negatively correlated to the healing as logistic analysis indicated（ P〈0. 05）. 2 cases with persistent symptoms of abdominal pain and diarrhea were eventually diagnosed as cases of crohn＇s disease. Conclusion nonspecific terminal ileum ulcers are mostly manifestations of non-specific chronic inflammation. The etiology has yet to be known. The prognosis is good and clinical follow-up can be conducted. Abdominal pain,diarrhea,alcohol consumption are the leading factors affecting the healing of non-specific small intestinal ulcers.