摘要
目的 探讨缺血性结肠炎（IC）的内镜表现、病理特征及危险因素,减少该病的误诊.方法 对101例患者的临床资料进行回顾性分析.所有患者都在14 d内进行结肠镜和病理检查,并对发病的危险因素进行Logistic分析.结果 IC患者主要表现为腹痛、腹泻、便血,偶伴低热等.IC轻症表现为点状出血、黏膜水肿、发脆、节段性红斑,散在糜烂和纵行溃疡,病变与正常黏膜分界清楚,严重者可表现为伪性、假息肉及假性肿瘤,管腔狭窄、结肠袋消失.病理表现为黏膜炎症,肉芽组织增生,腺体萎缩,固有层出血,黏膜下层可见含铁血黄素沉着的巨噬细胞.结论 IC缺乏特异性的内镜和病理表现,高血压、糖尿病、心房纤颤等是IC的危险因素（P＜0.05）,基础病史有助于IC的诊断.
Objective To evaluate the endoscopic findings and clinicopathologic characteristics of ischemic colitis and risk factors in older to avoid misdiagnosis. Methods 101 cases with ischemic colitis underwent endosopy within 14 days of onset of symptom in center of our hospital were retrospectively reviewed for their endosopic findings , clinicopathologic characteristics and risk factors. Results The common features of 101 cases included abdominal pain,diarrhea,or bloody diarrhea and hematochezia. Endoscopic visualization of mild ischemic colitis included pete-chial hemorrhages,edematous and fragile mucosa,segmental erythema,scattered erosion,longitudinal ulcerations,and sharply defined segment of involvement. Stricture ischemic colitis was characterised by full-thickness mucosa, lumens stricture and haustrations disappeared. Clinicpathological examination revealed mucosal inflammation accompanied by erosion,granulation tissue hyperplasis and gland atrophy,lamina propria hemorrhage,especially macrophages with he-mosiderin pigmentation in submucosa. Hypertension pressure, diabetes, atrial fibrilation were risk factors for ischemic colitis （ P 〈 0.05 ）. Conclusion Although there was on specific changes on endoscopic findings and pathologic characteristics , but combined with history, was helpfu in diagnosis of ischemic colitis and reducing the misdiagnosis.
出处
《中国基层医药》
CAS
2010年第15期2069-2070,I0001,共3页
Chinese Journal of Primary Medicine and Pharmacy
