缺血性结肠炎的临床与内镜表现

The clinical features and endoscopic findings of ischemic colitis

目的 :探讨缺血性结肠炎的临床与内镜特征表现。方法 :对 38例缺血性结肠炎患者的临床症状、体征及内镜检查资料进行回顾性分析。结果 :缺血性结肠炎好发于老年人 ,多伴有相关基础疾病 ,主要临床表现是急性下腹痛和便血。内镜检查提示病变主要发生在左半结肠 ,呈节段性分布 ,结肠粘膜高度水肿、充血、糜烂坏死及溃疡。大多数病例呈一过性表现 ,预后良好 ,1～ 2周可恢复正常。结论 :老年患者出现急性腹痛和便血时应警惕缺血性结肠炎的可能 ,内镜检查在明确诊断、早期治疗和判断预后上具有重要意义。

Objective:To analyze the clinical and endoscopic characteristics of ischemic colitis. Methods: The information of 38 cases with ischemic colitis such as clinical symptoms, physical and endoscopic pattern were reviewed. Results: Ischemic colitis usually occurred in elderly who complicated often with some basic diseases. The clinical predominant presentations were abdominal pain and bloody stool. The pathological changes, for instance, mucosal edema, congestion, erosion and ulceration found by endoscopy were located mainly in left colon with segmental form. In most cases these features were transitional and could be cured rapidly within 1-2 weeks The prognosis was good. Conclusion: ischemic colitis should be suspected in elderly patients with acute abdominal pain and bloody stool, early endoscopy play an important role in diagnosis, early treatment and prognosis.