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[目的]分析药物性结肠炎患者的临床特点、镜下表现及病变黏膜病理特点,提高对药物性结肠炎的认识及诊断率。[方法]回顾性分析2010~2015年期间诊断为药物性结肠炎患者80例的临床资料,并比较伪膜性结肠炎(18例)与出血性结肠炎(62例)的临床特点、结肠内镜下分布特点及病理学特点的差异。[结果](1)临床表现:伪膜性结肠炎主要表现腹痛+腹泻,出血性结肠炎主要表现腹痛+腹泻+血便,差异具有统计学意义(χ~2=9.64,P<0.05)。(2)结肠镜内镜下特点:伪膜性结肠炎主要表现为黏膜充血+水肿+糜烂+溃疡+伪膜,出血性结肠炎主要表现为黏膜充血+水肿+糜烂+溃疡+出血,差异具有统计学意义(χ~2=58.24,P<0.05)。(3)组织病理特点:伪膜性结肠炎主要以慢性炎症为主,出血性肠炎主要以急性炎症为主,差异具有统计学意义(χ~2=13.80,P<0.05)。[结论]对服用具有胃肠黏膜损伤的药物如抗生素、非甾体类药物后出现腹痛、腹泻、血便等症状,要高度怀疑药物性结肠炎,结合结肠镜检查和活检,即使在病理结果与药物性结肠炎病理不一致情况下,亦可考虑诊断该病。
[Objective] To analyze the clinical features, microscopic features of mucosal pathological changes in patients with drug-induced colitis and improve the understanding and diagnosis rate of drug-induced colitis. [Methods] The clinical data of 80 patients diagnosed as drug-induced colitis from 2010 to 2015 were retrospectively analyzed. The clinical features of pseudomembranous colitis (n = 18) and hemorrhagic colitis (n = 62) were compared. Microscopic distribution and pathological features of the differences. [Results] (1) Clinical manifestations: pseudomembranous colitis mainly abdominal pain + diarrhea, hemorrhagic colitis mainly abdominal pain + diarrhea + bloody stool, the difference was statistically significant (χ ~ 2 = 9.64, P <0.05). (2) colonoscopy Endoscopic features: pseudomembranous colitis mucosal hyperemia + edema + erosion + ulcer + pseudomembranous hemorrhagic colitis mucosal hyperemia + edema + erosion + bleeding, the difference is Statistical significance (χ ~ 2 = 58.24, P <0.05). (3) Histopathological features: Pseudomembranous colitis mainly chronic inflammation, hemorrhagic enteritis mainly acute inflammation, the difference was statistically significant (χ ~ 2 = 13.80, P <0.05). [Conclusion] The symptoms of abdominal pain, diarrhea and bloody stool after taking drugs with gastrointestinal mucosal injury such as antibiotics and non-steroidal drugs should be highly suspected of drug-induced colitis, combined with colonoscopy and biopsy, even if the pathological findings and Drug-induced colitis pathological inconsistency may also consider the diagnosis of the disease.