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结肠炎,缺血性

结肠炎,缺血性的相关文献在2001年到2021年内共计81篇,主要集中在内科学、临床医学、外科学 等领域,其中期刊论文81篇、专利文献10048篇;相关期刊37种,包括河北中医、中华老年多器官疾病杂志、中华内科杂志等; 结肠炎,缺血性的相关文献由270位作者贡献,包括吴本俨、孟立娜、关玉龙等。

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结肠炎,缺血性

-研究学者

  • 吴本俨
  • 孟立娜
  • 关玉龙
  • 周洪美
  • 姚健凤
  • 廖亮
  • 张旭
  • 张自妍
  • 江泳
  • 王智峰
  • 期刊论文
  • 专利文献

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    • 黄军荣
    • 摘要: 特发性肠系膜静脉硬化性肠炎是一种特殊且非常罕见的消化系统慢性缺血性肠疾病,临床以腹痛、腹胀、腹泻、大便不成形为主要的非典型表现,可伴恶心、呕吐等非特异症状,粪便潜血试验可阳性.临床常因对本病缺乏认识诊治延误.IMP可根据肠系膜线状钙化的影像学特征性表现和结肠壁增厚并肠系膜静脉、肠壁静脉管壁的纤维增厚并钙化为主要特征的组织病理学确诊,目前其病因和发病机制仍未明了.
    • 杨春晓; 刘佰纯; 丁凤荣; 佘美佳; 戴新羽; 段立伟
    • 摘要: 目的 分析缺血性结肠炎(IC)的临床特点,进一步提高该病诊断及治疗水平.方法 回顾性分析吉林大学第二医院2014年1月至2018年12月确诊的IC患者35例的临床表现、发病危险因素、结肠镜及腹部CT检查结果,总结其临床特点.结果 35例患者中有31例以突然发作的腹痛、鲜血便为主要表现.10例行腹部CT扫描的患者均见长范围肠壁增厚,厚度为(7.92±1.41)mm,增厚肠壁CT值明显下降,为(21.20±2.27) Hu;35例结肠镜检查中,累及降结肠、乙状结肠、横结肠、升结肠、全结肠者分别为42.86%、31.42%、20.00%、2.86%、2.86%,以左半结肠为主,可见簇状、条带状分布的黏膜红斑、瘀斑、糜烂,甚至溃疡;35例患者均未累及直肠.结论 IC的典型表现为突然发作的腹痛及鲜血便,急诊腹部CT对该病的早期诊断有明显的提示价值,结肠镜检查是该病的主要的诊断方法.
    • 吴春晓; 于欣; 杨爱国; 孟国瑞; 江玉霞
    • 摘要: 目的 观察补气活血化瘀法治疗慢性缺血性结肠炎的临床疗效.方法 将62例慢性缺血性结肠炎患者按照随机数字表法分为2组,对照组31例予常规抗炎、补液治疗,治疗组31例在对照组治疗基础加丹红注射液静脉滴注,以及补气活血化瘀中药汤剂口服、保留灌肠治疗.比较2组粪隐血试验(OBT)转阴时间,治疗前、治疗7 d、治疗2周C反应蛋白(CRP)、纤维蛋白原(FIB)、红细胞沉降率(ESR)变化,以及2组结肠镜疗效.结果 治疗组OBT转阴时间早于对照组(P0.05).治疗组结肠镜总有效率90.32%(28/31)高于对照组80.65%(25/31,P<0.05).结论 补气活血化瘀法治疗慢性缺血性结肠炎临床疗效肯定,能有效降低CRP、FIB,早期实现OBT转阴,改善结肠镜下表现.
    • 李晓宁
    • 摘要: 目的 分析缺血性肠炎患者的临床及内镜特点.方法 回顾性分析2015年 ~2019年大连市第三人民医院收治的130例缺血性肠炎患者的临床资料,分析一般资料,病因、临床表现、内镜特点及病理结果 .结果 共纳入130例患者,其中男性72例(55%),女性患者58例(45%),平均年龄(63.5±4.1)岁.腹痛118例(90.7%),便血106例(81.5%),腹胀30例(23.1%),恶心26例(20%),呕吐15例(11.5%),腹泻43例(33.1%),便秘18例(13.8%),发热45例(34.6%).结肠镜下主要表现为黏膜明显充血、水肿、糜烂、出血、溃疡.结肠受累情况:左半结肠为最常见受累部位,共99例,其中直肠受累8例;右半结肠受累者24例;结肠广泛受累者7例;合并结肠息肉42例.病理表现:组织黏膜水肿、淋巴细胞和中性粒细胞浸润,黏膜固有层出血,部分可见小血管内纤维素样血栓形成.结论 缺血性肠炎好发于存在动脉硬化基础疾病的中老年人,常表现为急性腹痛、血便,左半结肠最易受累.需重视内镜及病理检查,以防误诊,一旦确诊,应积极治疗.
    • 张自妍; 马建霞; 童依丽; 姚健凤
    • 摘要: Objective To summarize the clinical characteristics of ischemic colitis(IC)between the elderly and young/middle-aged patients.Methods Clinical data of 200 IC patients with definite diagnosis from June 2010 to December 2016 in our department were collected and retrospectively analyzed.The patients were divided into young/middle-aged group(0.05).The percentage of completely healed mucosa was 96.2%(75/78)in the young/middle-aged group,and was 91.0%(111/122)in the elderly group(P=0.162).Conclusion The major causes of IC are intestinal factors for young/middle-aged patients,while vascular factors for the elderly.Blood hypercoagulability is common in elderly IC patients.%目的 分析中青年和老年缺血性结肠炎(IC)的临床特点.方法 回顾性分析复旦大学附属华东医院消化内科2010年6月至2016年12月收治的200例IC患者,按照年龄分为0.05).中青年组黏膜完全愈合占96.2%(75/78),老年组黏膜完全愈合占91.0%(111/122),两组比较差异无统计学意义(P=0.162).结论 肠道因素是中青年IC患者的重要病因,血管因素是老年IC患者的重要病因.老年IC患者存在明显血液高凝状态.
    • 吴本俨; 徐世平
    • 摘要: Ischemic colitis (IC)is one of the major causes of acute lower gastrointestinal bleeding and usually occurs in the elderly. Hypoperfusion of the mesenteric microvasculature,even induced by constipation in the elderly,is by far the approximate mechanism. The clinical manifestations of IC vary depending on the extent and duration of ischemia. The presenting symptoms include sudden cramping abdominal pain;an urgent desire to defecate;and passage within 24 hours of bright red or maroon blood or bloody diarrhea. CT scan should be the first imaging modality of choice for patients with suspected IC to assess the distribution and phase of colitis. Early colonoscopy (within 48 hours of presentation)should be performed to confirm the diagnosis if without gangrene and perforation. Nonsurgical treatment approach usually includes bowel rest,intravenous fluid,electrolyte repletion,correction of precipitating conditions and antibiotic usage,occasionally with administration of total parenteral nutrition. It has been shown that isolated right colonic ischemia (IRCI)has a worse outcome than ischemia affecting other regions of the colon. Surgical intervention should be considered in the presence of IRCI or pan-colonic ischemia and in the presence of gangrene.%缺血性结肠炎(IC)多见于老年人群,是急性下消化道出血的主要原因之一.各种原因甚至老年人便秘所致的低血流灌注状态为其主要发病机制.临床表现与缺血累及范围和时间有关.发作性腹部疼痛不适伴排便急迫感、24 h内出现鲜红色或暗红色血便或血性腹泻,是老年人IC的主要临床表现.腹盆腔CT检查是明确肠道受累部位和病变范围首选的检查方法.结肠镜检查为确诊方法,如无肠坏死或肠穿孔,应于48 h内行结肠镜检查.内科治疗包括肠道休息、静脉补液、纠正电解质紊乱、治疗原发疾病和应用抗菌药物,必要时予肠外营养.与其他部位的结肠缺血相比,孤立性右半结肠缺血预后较差.对于孤立性右半结肠或全结肠缺血以及存在肠坏死的患者,应及时请外科会诊讨论有无手术治疗的可能性.
    • 赵奋华; 单康飞; 黄朝晖; 朱伟华
    • 摘要: Objective: To investigate the clinical features and CT signs of ischemic colitis (IC). Methods:Retrospective data analysis of 39 patients' with IC confirmed by CT and colonoscopy. All patients underwent CT plain scan and dual-phase enhanced scan and some underwent abdominal CTA examination. Results: Of 39 patients, ascending colon was found in 9 cases, transverse colon in 13 cases, splenic flexure of colon in 27 cases, descending colon in 36 cases, sigmoid colon in 11 cases and 1 case of rectum. The colonic wall had a different degree of thickening, with an average thickness of 14.3 mm. The density of all invovling intestinal walls de-creased, and the enhancement of the intestinal wall weakened. Intestinal dilatation was observed in 7 cases and 10 cases showed mesenteric edema and exudation. A total of 25 cases of abdominal aortic calcification plaque were detected, 8 cases involved the origin of the superior mesenteric artery and inferior mesenteric artery. Conclusion:The typical CT manifestations of IC included colonic wall thickening and edema, weakened enhancement and surrounding mesenteric edema and exudation. The descending colon and the splenic flexure of colon involvement were the most common. After enhanced scan, the "Reticulated python sign" maybe valuable for the evaluation of intestinal wall ischemia.%目的:探讨缺血性结肠炎(IC)的临床特点及CT征象.方法:回顾性分析经CT、结肠镜证实的39例IC患者的临床及CT资料,行CT平扫及双期增强扫描,部分病例行腹部CTA检查.结果:39例患者中累及升结肠9例,横结肠13例,结肠脾曲27例,降结肠36例,乙状结肠11例,直肠1例.结肠壁不同程度增厚,平均厚度为14.3 mm,所有病变肠壁密度减低,强化程度减弱,7例肠管有扩张,10例肠系膜水肿渗出,共检出腹主动脉钙化斑块25例,8例累及肠系膜上、下动脉开口处.结论:IC典型CT表现为结肠壁的增厚水肿、强化减弱、周围系膜内渗出,以降结肠及结肠脾曲受累最常见,增强扫描"蟒纹征"对肠壁缺血情况的评价有重要参考价值.
    • 林琳; 吴静
    • 摘要: 目的 分析缺血性结肠炎(IC)患者的临床和结肠镜特点,以协助更好地诊断和治疗.方法 回顾性分析2009—2016年于首都医科大学附属北京世纪坛医院住院的初发IC患者的临床资料,分析患者的一般资料、临床表现、实验室检查和结肠镜检查特点.结果 共纳入74例初发IC患者,女40例(54.1%),平均年龄(68.3±11.3)岁,≥65岁45例(60.8%).主要临床症状有便血〔89.2%(66/74)〕、下腹痛〔83.8%(62/74)〕、恶心〔25.7%(19/74)〕、便秘〔24.3%(18/74)〕、腹胀〔24.3%(18/74)〕.伴随的基础疾病有高血压〔60.8%(45/74)〕、外周动脉硬化〔41.9%(31/74)〕、高脂血症〔35.1%(26/74)〕、腹部手术史〔32.4%(24/74)〕和冠状动脉粥样硬化性心脏病〔29.7%(22/74)〕.结肠镜下主要表现为充血、水肿、出血、糜烂和溃疡.52例患者为左半结肠受累,4例合并结肠恶性肿瘤.部分患者血糖、C反应蛋白、D-二聚体水平升高.20例患者血管超声和/或CT血管造影发现了不同程度的腹腔血管狭窄.结论 IC好发于女性和老年人,左半结肠是最常见的受累部位,存在IC合并结肠恶性肿瘤的情况,应重视结肠镜检查以减少误诊和漏诊,同时注意预防可逆因素所致IC.%Objective To analyze the clinical and endoscopic features of ischemic colitis (IC),in order to provide a reference for the diagnosis and treatment of the disease.Methods We retrospectively analyzed the demographic data, clinical manifestations,results of laboratory examination and colonoscopy characteristics of the IC patients with who received initial treatment in Beijing Shijitan Hospital,CMU from 2009 to 2016.Results Totaled 74 cases of IC were enrolled.Among them,54.1%(40/74) were females,60.8%(45/74) aged ≥ 65,the mean age was (68.3±11.3) years.Their main clinical manifestations were hematochezia 〔89.2%(66/74)〕,hypogastralgia〔83.8%(62/74)〕,nausea〔25.7% (19/74)〕,constipation〔24.3%(18/74)〕 and abdominal distension 〔24.3%(18/74)〕.The common accompanying basic diseases found in them were hypertension 〔60.8%(45/74)〕,peripheral artery atherosclerosis 〔41.9%(31/74)〕, hyperlipidemia 〔35.1%(26/74)〕,history of abdominal surgery〔32.4%(24/74)〕 and coronary heart disease 〔29.7% (22/74)〕.The colonoscopy identified hyperemia,edema,hemorrhage,erosion and ulcer in the colon.Fifty-two patients had left colonic involvement,and 4 of them were accompanied by malignant colonic neoplasm.The levels of fasting blood glucose, C-reactive protein and D-dimer were increased in some patients.Twenty patients were found with different degrees of abdominal artery stenosis by vascular ultrasound /CT angiography.Conclusion IC occurs mostly in the female and the elderly.The left colon is one of the most involved areas.Some patients with IC have malignant colonic neoplasm.It is important to bear in mind that colonoscopy can reduce the possibilities of misdiagnosis and missed diagnosis and the reversible factors that can lead to IC.
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