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目的探讨缺血性结肠炎(IC)的临床和内镜下的特点,为其早期诊断及治疗提供参考。方法回顾性分析2000年7月～2008年6月期间本院消化内科确诊28例IC患者的临床资料:包括临床及结肠镜下表现,病理检查及相关的化验检查,诊疗经过和转归情况。结果患者28例,男∶女为1∶6,60岁以上22例,占78.5%;伴有相关基础疾病患者占57%。临床上多以腹痛(82.1%)、腹泻(28.5%)、血便(92.8%)为首发表现,或伴有其他消化道症状。本组28例均行结肠镜检查,其中一过型26例,狭窄型2例,无坏死型者。病理学检查为非特异性炎症表现。病变部位主要于左伴结肠25例(89%),均予以扩血管、抗炎等内科保守治疗。28例均痊愈。平均住院时间为8d。结论IC好发于老年女性,多急性发作,大多伴有基础疾病。其临床典型表现为突然腹痛和便血。结肠镜检查是早期诊断IC的主要方法。早期诊断,及时治疗预后良好。
Objective To investigate the clinical and endoscopic features of ischemic colitis (IC) and provide a reference for its early diagnosis and treatment. Methods The clinical data of 28 IC patients diagnosed in our department from July 2000 to June 2008 were retrospectively analyzed. The clinical data including clinical and colonoscopic findings, pathological examination and related laboratory tests, diagnosis, treatment and prognosis were retrospectively analyzed. Results 28 patients, male: female 1: 6, 22 patients over the age of 60, accounting for 78.5%; associated with underlying diseases accounted for 57% of patients. Clinically, abdominal pain (82.1%), diarrhea (28.5%), bloody stool (92.8%) as the first episode, or accompanied by other gastrointestinal symptoms. The group of 28 patients underwent colonoscopy, including one over 26 cases, 2 cases of stenosis, no necrosis type. Pathological examination for the performance of non-specific inflammation. Lesions mainly in the left colon with 25 cases (89%), are to vasodilators, anti-inflammatory and other medical conservative treatment. 28 cases were cured. The average length of stay was 8 days. Conclusion IC occurs in older women, more acute attacks, mostly associated with underlying diseases. The clinical manifestations of sudden abdominal pain and blood in the stool. Colonoscopy is the primary method of early diagnosis of ICs. Early diagnosis, timely treatment of a good prognosis.