CAJ | 학술논문

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.
목적 탐토결혈성결장염(IC)적내경표현、병리특정급위험인소,감소해병적오진.방법 대101례환자적림상자료진행회고성분석.소유환자도재14 d내진행결장경화병리검사,병대발병적위험인소진행Logistic분석.결과 IC환자주요표현위복통、복사、편혈,우반저열등.IC경증표현위점상출혈、점막수종、발취、절단성홍반,산재미란화종행궤양,병변여정상점막분계청초,엄중자가표현위위성、가식육급가성종류,관강협착、결장대소실.병리표현위점막염증,육아조직증생,선체위축,고유층출혈,점막하층가견함철혈황소침착적거서세포.결론 IC결핍특이성적내경화병리표현,고혈압、당뇨병、심방섬전등시IC적위험인소(P＜0.05),기출병사유조우IC적진단.
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.