缺血性结肠炎临床特点、内镜特征及转归分析

Analysis of clinical characteristics, endoscopic features, and prognosis of ischemic colitis

目的 分析缺血性结肠炎临床特点、内镜特征和转归情况.方法 选取本院2012年3月至2016年3月收治的90例缺血性结肠炎患者予以回顾性分析,对其临床特点、内镜特征和转归情况进行观察与分析.结果 中老年人为缺血性结肠炎多发人群,此类疾病通常合并糖尿病、高血压、高脂血症或动脉粥样硬化、异常糖耐量等疾病.结肠镜查看显示：病变部位主要累及全结肠1例（1.11％）,直肠2例（2.22％）,盲肠与升结肠4例（4.44％）,横结肠7例（7.78％）,左半结肠76例（84.44％）,且病变累及多部位时呈现节段分布,1例（1.1 1％）坏疽型缺血性结肠炎,89例（98.89％）非坏疽型缺血性结肠炎.经2-4周治疗后再次行结肠镜检查,发现患者临床症状基本消失,病变好转或者消失.结论 临床需加强对伴高血压、糖尿病等基础疾病老年患者便血、下腹痛的重视度,且充分利于结肠镜进行检查,以便及早确诊,为疾病治疗提供重要参考,促进患者预后改善.

Objective To analyze the clinical characteristics,endoscopic features,and prognosis of ischemic colitis.Methods Clinical data of 90 patients with ischemic colitis admitted to our hospital from March 2012 to March 2016 was retrospectively analyzed.The clinical features,endoscopic features,and clinical outcomes were observed and analyzed.Results Ischemic colitis had a predilection for the elderly.The disease was often associated with diabetes,hypertension,hyperlipidemia or atherosclerosis,abnormal glucose tolerance,and other diseases.Colonoscope showed that the lesion involved whole colon in 1 case （1.11%）,rectum in 2 cases （2.22%）,cecum and ascending colon in 4 cases （4.44%）,transverse colon in 7 cases （7.78%）,left semicolon in 76 cases （84.44%）,and segmental distribution when lesions involving multiple sites,1 cases （1.11%） of gangrenous ischemic colitis,89 cases （98.89%） of non gangrenous ischemic colitis.Colonoscope showed that clinical symptoms of patients almost disappeared,the lesions improved or disappeared after 2-4 weeks＇ treatment.Conclusions We should pay attention to hematochezia,abdominal pain in elderly patients with hypertension,diabetes,and other underlying diseases,which is fully conducive to colonoscopy examination for early diagnosis,and provides an important reference for disease therapy,to improve the prognosis of patients.