目的 通过随访分析54例非特异性小肠溃疡患者,总结其特征与自然病程,探讨其预后及预测克罗恩病(Crohn's disease,CD)等其他疾病的可能性.方法 回顾性纳入2015年7月1日至2017年7月31日郑州大学第一附属医院诊断为非特异性小肠溃疡患者54例,分析其临床表现、内镜表现、病理特点、诊疗及随访情况.结果 共纳入54例非特异性小肠溃疡患者,男女比例为1∶1.07,平均随访11.6个月后,5例发展为CD,1例诊断为小肠肿瘤,其余皆诊断为非特异性小肠溃疡.整个随访过程中,未见明显严重并发症,如肠梗阻、穿孔等.结论 非特异性小肠溃疡由多种病因造成,早期内镜、活检组织病理表现不典型,诊治困难,需长期随访.对溃疡持续存在,症状反复,并伴ESR、CRP持续升高的病例需密切随访,早期鉴别CD等其他相关疾病.%Objective To explore the prognosis of nonspecific small bowel ulcer through follow-up,and the possibility of early diagnosis of Crohn's disease (CD),or any other diseases.Methods Fifty-four cases suspected or confirmed as nonspecific small bowel ulcer from Jul.1st,2015 to Jul.31st,2017 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed,and their clinical manifestations,endoscopic features,pathological features,diagnosis and follow-up were summarized.Results Fifty-four patients with nonspecific small bowel ulcer (with a male-to-female ratio of 1∶ 1.07) were collected.The patients were followed-up for 11.6 months on average,and 5 patients developed CD,1 patient developed small bowel tumor,the rest were diagnosed as nonspecific small bowel ulcer.In the whole process of follow-up,no severe complications such as intestinal obstruction and perforation occurred.Conclusion Nonspecific small bowel ulcer is caused by multiple factors and has no specific endoscopic or histopathological features,which result in difficult diagnosis.The patients with persistent ulcer and continuously elevated erythrocyte sedimentation rate and C reactive protein (CRP) should be closely followed-up for early diagnosis of CD or other related diseases.
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