CAJ | 학술논문

目的了解缺血性结肠炎在我国的发病趋势、临床特征及预后,增加对缺血性结肠炎的认识.方法检索中国知网全文数据库和维普中文科技期刊数据库,并对检出文献进行分析,检索最后时间为2014年5月15日.结果共得到符合条件的文献324篇,出版时间从1982-2013年.报告例数9202,男3973例,女5229例,男女比例1∶1.32.校正平均年龄为(63.6±7.8)岁.文献数量及报告病例数在2002年以后开始升高.估计累计发病比例存在地域差异,北方地区高于其他地区(x2 =1097.95,P=0.000).伴随疾病以高血压、心脏病、糖尿病、高脂血症以及便秘最多见,不同地域及不同时代间比较,差异有统计学意义.药物、肠镜检查、外伤手术、低血容量可能为诱发因素.腹痛、腹泻/便意、便血为主要症状.CT检查简便易行,肠镜检查是明确诊断的主要方法.病变部位主要位于乙状结肠、降结肠及脾曲,以单个部位受累为主,全结肠病变少见,直肠较少受累.亚型以一过型最多,病变多位于乙状结肠、降结肠及脾曲等左半结肠,内科药物治疗为主,预后大多良好.坏疽型受累部位多位于横结肠肝曲、升结肠以及回盲部等右半结肠,首选手术治疗,但病死率较高.结论缺血性结肠炎发病率逐年增加,女性多见,心血管疾病是高危因素.临床表现以腹痛、腹泻/便意、便血为主.病变部位主要位于乙状结肠、降结肠及脾曲.亚型以一过型为主,预后良好.
목적 료해결혈성결장염재아국적발병추세、림상특정급예후,증가대결혈성결장염적인식.방법 검색중국지망전문수거고화유보중문과기기간수거고,병대검출문헌진행분석,검색최후시간위2014년5월15일.결과 공득도부합조건적문헌324편,출판시간종1982-2013년.보고례수9202,남3973례,녀5229례,남녀비례1∶1.32.교정평균년령위(63.6±7.8)세.문헌수량급보고병례수재2002년이후개시승고.고계루계발병비례존재지역차이,북방지구고우기타지구(x2 =1097.95,P=0.000).반수질병이고혈압、심장병、당뇨병、고지혈증이급편비최다견,불동지역급불동시대간비교,차이유통계학의의.약물、장경검사、외상수술、저혈용량가능위유발인소.복통、복사/편의、편혈위주요증상.CT검사간편역행,장경검사시명학진단적주요방법.병변부위주요위우을상결장、강결장급비곡,이단개부위수루위주,전결장병변소견,직장교소수루.아형이일과형최다,병변다위우을상결장、강결장급비곡등좌반결장,내과약물치료위주,예후대다량호.배저형수루부위다위우횡결장간곡、승결장이급회맹부등우반결장,수선수술치료,단병사솔교고.결론 결혈성결장염발병솔축년증가,녀성다견,심혈관질병시고위인소.림상표현이복통、복사/편의、편혈위주.병변부위주요위우을상결장、강결장급비곡.아형이일과형위주,예후량호.
Objective To investigate the incidence trends,clinical features and prognosis of ischemic colitis (IC) in China,and improve the level of diagnosis and treatment of IC.Methods China National Knowledge Infrastructure and VIP Chinese Science and Technology Periodical Database were searched.The ending date of search was May 15,2014.Results A total of 324 references were found,which were published from 1982 to 2013.There were 9202 cases reported,3973 cases of males and 5229 cases of females,with the male/female ratio of 1 ∶ 1.32 and mean age of (63.6±7.8)years.The amount of references and cases reported began to rise after 2002.Estimated ratio of cumulative incidence was higher in the north than in other areas of China (x2 =1097.95,P=0.000).The most common IC accompanying diseases were hypertension,heart diseases,diabetes,hyperlipidemia and constipation.There were statistically significant differences in the accompanying diseases between different regions and different times.Drugs,enteroscopy,surgery and low blood volume might be the precipitating factors.Patients commonly complained of abdominal pain,diarrhea/ desiring to defecate and hematochezia.Computed tomography was feasible in detecting lesions.Colonoscopy was the main method for diagnosis.The lesions were most common located in the left half colon including sigmoid colon,descending colon and splenic flexure,with typically in a segmental manner.Pan-colon involvement or rectum involvement rarely occurred.Type of transient lesion was the predominant subtype,which was generally managed non-operatively with good prognosis.Different from the type of transient lesion,pathological changes in gangrenous type were located in the right half colon including hepatic flexure of transverse colon,ascending colon and ileocecal junction.Gangrenous type required prompt surgical intervention but the mortality was much higher.Conclusions Incidence of CI has been increasing year by year.Patients who complain of abdominal pain,diarrhea/desiring to defecate and hematochezia should be considered as IC,particularly in the elderly women and patients with cardiovascular disease.Diseased regions are mainly located in sigmoid colon,descending colon and splenic flexure.Transient colitis is the predominant subtype,which have good prognosis.