134例回盲部病变临床分析

摘要

Objective To investigate the clinical characteristics and diagnosis and treatment of ileocecal disease.Methods The general data,clinical manifestations,imaging examinations,colonoscopy and pathological examination and diagnosis of 134 patients in our hospital with ileocecal disease from September 2009 to March 2016 were collected.The clinical characters were summarized by retrospective analysis.Results A total of 134 cases with ileocecal disease were collected,and 36(26.87％)of them were ileocecal cancer,30(22.39％)of them were inflammatory bowel disease,26(19.40％)of them were intestinal tuberculosis.The main clinical manifestations of ileocecal lesion were abdominal pain,abdominal distention,diarrhea,bloody stool,etc.The colonoscopy imaging showed mucosal hyperemia,edema,erosion,ulcer and tumors on the intestinal tract.The benign lesions mainly showed ulcer with mucosal erosion and edema,and the ileocecal cancer showed neoplasm.CT examination was the common imaging method,and 93(69.40％)cases got tested.49 cases had operation,in which 7 cases had misdiagnosed before operation,and the rate of misdiagnosis was 14.28％.Conclusion The ileocecal disease is mainly benign lesions,and the process of diagnosis is complex;the rate of misdiagnosis is a little high.%目的 探讨回盲部病变的临床特征及诊断治疗方案.方法 收集2009年9月至2016年3月该院134例回盲部病变患者的一般资料、临床表现、影像学检查、结肠镜及病理检查和诊断等资料,采用回顾性分析方法,归纳其临床特征.结果 共收集回盲部病变134例,其中回盲部癌36例(26.87％),炎症性肠病30例(包括溃疡性结肠炎和克罗恩病,22.39％),肠结核26例(19.40％).其临床表现主要为腹痛、腹胀、腹泻、便血等.肠镜下主要表现为黏膜充血肿胀、红斑、糜烂、溃疡及肿块样新生物.良性疾病(除回盲部癌及淋巴瘤以外病例)以溃疡形成伴局部黏膜充血、肿胀为主,回盲部癌则以回盲部新生物多见.影像学检查以腹部CT为主,共93例(69.40％)行该检查.手术治疗49例,术前诊断错误7例,误诊率14.28％.结论 回盲部病变总体以良性疾病为主,诊疗过程复杂,确诊困难,误诊率较高.