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目的评价重型溃疡性结肠炎(UC)的临床疗效及治疗转归,寻找提示疗效及预后的相关因素。方法回顾性分析41例住院重型 UC 患者的病例资料。记录临床表现及诊疗经过,对柳氮磺胺吡啶(SASP)/5-氨基水杨酸(5-ASA)、皮质激素、免疫抑制剂等药物疗效进行评价,并对手术病例进行分析。结果重型 UC 患者占同期住院 UC 患者的28.5%(41/144),其中17.1%(7/41)伴肠道外表现;92.7%(38/41)为全结肠型病变,初发型、慢性持续型及慢性复发型分别占36.9%(15/41)、36.9%(15/41)和26.8%(11/41);控制急性发作主要药物为激素,占61.0%(25/41);31例(75.6%)重型 UC 经药物治疗缓解,7例(17.1%)最终手术治疗。发病年龄轻、全结肠病变、低血红蛋白、低血清白蛋白是提示药物疗效差、需手术治疗的相关因素。结论对于重型 UC,除积极系统的药物治疗外,应及时评估药物疗效及手术需求。
Objective To evaluate the clinical efficacy and prognosis of patients with severe ulcerative colitis (UC) and find out the related factors that suggest the efficacy and prognosis. Methods A retrospective analysis of 41 cases of hospitalized patients with severe UC patients. The clinical manifestations and diagnosis and treatment were recorded. The therapeutic effects of sulfasalazine (SASP) / 5-aminosalicylic acid (5-ASA), corticosteroids and immunosuppressive agents were evaluated and the surgical cases were analyzed. Results Severe UC patients accounted for 28.5% (41/144) of the hospitalized UC patients in the same period, of which 17.1% (7/41) had parenteral manifestations. 92.7% (38/41) had colon-type lesions. The primary type and chronic persistent type And chronic recurrent type accounted for 36.9% (15/41), 36.9% (15/41) and 26.8% (11/41), respectively. The main drug for controlling acute exacerbation was hormone (61.0%, 25/41) 75.6%) patients with severe UC were relieved by medication and 7 patients (17.1%) were finally surgically treated. Age of onset of disease, colon disease, low hemoglobin, low serum albumin is prompted the poor efficacy of the drug, the need for surgical treatment of the relevant factors. Conclusion For severe UC, in addition to aggressive systemic drug therapy, timely evaluation of drug efficacy and surgical needs.