论文部分内容阅读
本文随访了病程10年以上的长期溃疡性结肠炎23例。从临床过程、结肠镜改变及结肠粘膜组织学变化三个方面估计其预后。经就诊初期积极治疗后临床缓解率为100％。但继之均呈慢性复发型,无1例痊愈。6例因此健康情况下降,迁延不愈可能与维持治疗疗程不足,用药不当有关。随访时结肠镜改变不如初治时广泛及严重。组织学改变以萎缩扁性改变占优势,并发现3例轻度异型增生,其中2例为腺瘤,已被摘除,1例发生于扁平粘膜。但未见高度异型增生及癌变。作者提出本病维持治疗应视病情严重程度及复发频度酌定,最短不应少于1年。溃结恶变倾向值得重视,对异型增生这一癌前病变的识别至关重要。1年1度的结肠镜检,多部位活检的监视癌变方法值得倡导。
This article followed the course of 10 years or more long-term ulcerative colitis in 23 cases. From the clinical course, colonoscopy changes and colonic histological changes in three aspects of prognosis. After active treatment early treatment clinical remission rate was 100%. However, all were followed by chronic recurrent type, no one recovered. 6 cases of decline in health, delayed healing may be insufficient to maintain the treatment course, improper medication. Colonoscopy at follow-up is less extensive and severe than initial treatment. Histological changes to shrink atrophy changes dominant, and found 3 cases of mild dysplasia, of which 2 cases of adenoma, has been removed, 1 case occurred in the flat mucosa. But no abnormal hyperplasia and cancer. The authors suggest that the maintenance of the disease should be treated as the severity of the disease and the frequency of recurrence discretion, the shortest should not be less than 1 year. It is important to note the malignant transformation tendency of dysplasia and the identification of dysplasia and precancerous lesions. 1 year colonoscopy, multi-site biopsy monitoring of cancer is worth promoting.