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目的:探索放大肠镜在重症急性胰腺炎(SAP)早期肠黏膜屏障功能障碍导致的结肠黏膜损伤诊断中的价值。方法:对35例早期SAP病人进行放大肠镜检查,观察结肠黏膜有无损害,并取活检进行病理学光镜和电镜检查,同时对其进行APACHEⅡ评分、胃肠功能评分、胰周组织感染发生率统计。结果:71.4%(25/35)的早期SAP病人在放大肠镜检查中发现有结肠黏膜损伤,包括黏膜水肿、出血、糜烂。77.1%(27/35)的病人活检组织病理检查发现异常,包括黏膜上皮脱落、紧密连接缩短、细胞间分离。放大肠镜发现结肠黏膜损伤的病人其病理检查异常率、APACHEⅡ评分、胃肠功能评分、胰周感染发生率均高于未发现结肠黏膜损伤的病人。结论:对早期SAP病人进行放大肠镜检查,能够评估病人疾病的严重程度,预测病程进展中发生胰周感染的概率。
Objective: To explore the value of magnifying colonoscopy in the diagnosis of colonic mucosal injury caused by early intestinal mucosal dysfunction in patients with severe acute pancreatitis (SAP). Methods: A total of 35 cases of early stage SAP patients were enrolled in this study. The colonic mucosa was examined with or without colon biopsy. Pathological examination was performed with light microscopy and electron microscopy. APACHEⅡscore, gastrointestinal function score and peripancreatic tissue infection were also observed Rate statistics. Results: In 71.4% (25/35) of the early SAP patients, colonic mucosal injury was found in the magnifying colonoscopy, including mucosal edema, hemorrhage and erosion. 77.1% (27/35) of patients biopsies found abnormal histopathological examination, including mucosal epithelial shedding, tight junction shortening, cell separation. Patients with colon mucosal lesion enlarged colonoscopy showed abnormal rates of pathological examination, APACHEⅡscore, gastrointestinal function score and peripancreas infection in patients with colon mucosal lesion. CONCLUSIONS: Magnifying colonoscopy in patients with early stage SAP can assess the severity of the patient’s disease and predict the probability of peripancreas infection during the course of the disease.