论文部分内容阅读
目的探讨慢性放射性肠炎的临床特征及诊疗效果。方法选取2009年1月—2011年1月广西医科大学第一附属医院收治的慢性放射性肠炎患者15例,回顾性分析患者的临床症状、体征及随访情况。结果患者出现血便12例,腹痛10例,腹泻5例,肛门疼痛4例,肠梗阻2例;肠镜表现:累及直肠和乙状结肠10例,累及直肠4例,累及乙状结肠1例;镜下表现:单个或多个溃疡9例,黏膜潮红、水肿、糜烂5例,肠腔狭窄4例,黏膜活动性出血1例;放射性肠损害:Ⅰ度2例,Ⅱ度9例,Ⅲ~Ⅳ度4例。随访期间Ⅰ度患者2例,症状好转;Ⅱ度患者9例,其中症状减轻2例,症状反复3例,病情进展4例;Ⅲ~Ⅳ度患者4例,症状未改善。常规治疗后患者治愈0例,有效4例,无效11例,总有效率为26.7%。结论慢性放射性肠炎的治疗效果不理想,应进一步探索新的治疗方法,以提高患者的远期疗效及生活质量。
Objective To investigate the clinical features and diagnosis and treatment of chronic radiation enteritis. Methods Fifteen patients with chronic radiation enteritis admitted to the First Affiliated Hospital of Guangxi Medical University from January 2009 to January 2011 were retrospectively analyzed. The clinical symptoms, signs and follow-up were retrospectively analyzed. Results There were 12 cases of bloody stool, 10 cases of abdominal pain, 5 cases of diarrhea, 4 cases of anal pain and 2 cases of intestinal obstruction. The colonoscopy showed 10 cases of rectum and sigmoid colon, 4 cases of rectum and 1 case of sigmoid colon. One or more ulcers in 9 cases, mucosal flushing, edema, erosion in 5 cases, intestinal stenosis in 4 cases, mucosal active bleeding in 1 case; radiation damage: Ⅰ degree in 2 cases, Ⅱ in 9 cases, Ⅲ ~ Ⅳ degrees in 4 cases . During the follow-up period, 2 patients with grade Ⅰ had better symptoms; 9 patients with grade Ⅱ, 2 patients with symptom relief, 3 patients with repeated symptoms and 4 patients with disease progression; 4 patients with grade Ⅲ ~ Ⅳ degree and no improvement in symptoms. After treatment, 0 cases were cured, 4 cases were effective and 11 cases were ineffective. The total effective rate was 26.7%. Conclusion The treatment effect of chronic radiation enteritis is not satisfactory. New treatments should be further explored to improve the long-term efficacy and quality of life of patients.