论文部分内容阅读
目的总结克罗恩病的临床特点,提高早期诊断水平,减少误诊率。方法回顾性分析28例克罗恩病患者的临床资料,对其临床特点、病变、肠镜表现、影像学表现、病理改变进行总结。结果临床表现为腹痛26例(92.8%),腹泻9例(32.1%),消化道出血8例(28.55%)。病变累及小肠17例(64%),结肠10例(39%)。结肠镜是末端回肠和结肠病变的主要诊断手段。肠镜下可见不同病期的多样性表现。11例(39.3%)经多次内镜及病理诊断,17例(60.7%)经手术、病理组织学检查证实。结论克罗恩病临床表现多样性,易误诊。肠镜检查在诊断中起关键作用,内镜联合病理活检,加强临床和病理医师沟通是及时、正确诊断的关键。重视病理组织学微肉芽肿特点,可提高非干酪样肉芽肿检出率。
Objective To summarize the clinical features of Crohn’s disease, improve the early diagnosis and reduce the misdiagnosis rate. Methods The clinical data of 28 Crohn ’s disease patients were retrospectively analyzed. The clinical features, lesions, colonoscopy, imaging findings and pathological changes were summarized. Results The clinical manifestations were abdominal pain in 26 cases (92.8%), diarrhea in 9 cases (32.1%) and gastrointestinal bleeding in 8 cases (28.55%). Lesions involving the small intestine in 17 cases (64%), colon 10 cases (39%). Colonoscopy is the primary diagnostic tool for terminal ileum and colonic lesions. Colonoscopy showed different stages of the diversity of performance. Eleven cases (39.3%) were diagnosed by multiple endoscopy and pathology, and 17 cases (60.7%) were confirmed by surgery and histopathology. Conclusion The clinical manifestations of Crohn’s disease are diverse and easily misdiagnosed. Enteroscopy in the diagnosis plays a key role in endoscopic biopsy combined with clinicians and pathologists to enhance communication is timely and correct diagnosis of the key. Emphasis on histopathological characteristics of micro-granuloma can increase the detection rate of non-caseous granulomas.