论文部分内容阅读
目的探讨结肠镜诊断克罗恩病的正确性以及与活检配合诊断的重要性。方法比较27例克罗恩病侵犯结肠患者的结肠镜及活组织学检查资料,分析与总结具有诊断意义的特点。结果本组27例患者多为混合型,即多数患者结肠合并其他部位病变(共26例次,占96·3%),单独侵犯结肠者仅4例(14·8%)。结肠镜下可见不同病期的多样性表现(破坏与修复/增殖性病变重叠出现)、以及节段性分布与多部位侵犯的黏膜病变,并有肠管狭窄、变形及增厚感等特点。18例结肠镜诊断结果经活检(9例)及手术后病理学检查(9例)对照证实,诊断正确率为66·7%。活检组织学特点为淋巴细胞聚集,病灶呈局灶性分布,部分标本可见黏膜下层增宽、裂隙状/口疮样溃疡、纤维化及肉芽肿(本组检出率30·8%)等。结论克罗恩病侵犯结肠较常见,多具有较突出的特征性结肠镜表现,并可作出明确诊断。活检组织学检查可进一步支持诊断可靠性。
Objective To explore the correctness of colonoscopy in the diagnosis of Crohn’s disease and its importance in diagnosis with biopsy. Methods The data of colonoscopy and biopsy in 27 patients with Crohn ’s disease who had colon cancer were compared, and the characteristics of diagnosis were analyzed and summarized. Results Most of the 27 patients in this group were mixed, that is, most of the patients had lesions of the colon combined with other parts (26 cases, 96.3%) and only 4 cases (14.8%) of the colon alone. Colonoscopy showed different stages of the diversity of performance (damage and repair / proliferative lesions overlap), and segmental distribution and multi-site invasion of mucosal lesions, and intestinal stenosis, deformation and thickened flu and so on. 18 cases of colonoscopy diagnosis by biopsy (9 cases) and postoperative pathological examination (9 cases) control confirmed that the diagnostic accuracy was 66.7%. Biopsy histological features of lymphocyte aggregation, lesions were focal distribution, some of the specimens can be found in the submucosa widened, fissure / aphthous ulcer, fibrosis and granuloma (30.8% detection rate in this group) and so on. Conclusion Crohn’s disease is more common in the colon, with more prominent features of colonoscopy, and can make a clear diagnosis. Biopsy histology may further support diagnostic reliability.