摘要
目的:总结黄河三角洲地区小肠溃疡患者的病因构成、内镜表现及临床特点,为临床诊治提供依据.方法:回顾性分析 2020 年 5 月 1 日—2023 年 3 月 1 日于滨州医学院附属医院经小肠镜或胶囊内镜首次诊断为小肠溃疡的 135 例患者的临床资料.结果:黄河三角洲地区小肠溃疡多发于 40～59 岁,男女比例为 1.55︰1.小肠溃疡的病因主要以克罗恩病最多见,临床表现多为腹痛、腹泻、便血和黑便,影像学检查特点为小肠管壁增厚、肠系膜淋巴结肿大及小肠管腔狭窄.小肠镜及胶囊内镜检出率分别为26.83%及 8.67%,常见溃疡部位为回肠、回盲部和空肠,内镜下溃疡特点以不规则样、纵行、环形、节段性为主,病理改变主要是黏膜慢性炎和伴炎细胞浸润.结论:小肠溃疡的病因复杂,临床特点缺乏特异性,小肠镜及胶囊内镜有助于小肠溃疡的诊断,但内镜下的表现常有重叠,病理活检在疾病的诊断中仍具有一定的局限性,应进一步探究CT等辅助检查在小肠溃疡诊断及鉴别诊断中的作用.
Abstract
Objective:To summarize the etiology composition,endoscopic manifestations,and clinical characteristics of patients small intestinal ulcer patients in the Yellow River delta area,providing a basis for clinical diagnosis and treatment.Method:The clinical data of 135 patients who were first diagnosed with small intestinal ulcer by enteroscopy or capsule endoscopy in Binzhou Medical University Hospital from May 1st,2020 to March 1st,2023 were retrospectively analyzed.Result:In the Yellow River delta area,small intestinal ulcer occurred mostly in the 40-59 years old,the male to female ratio was 1.55︰1.The most common etiology of small intestinal ulcer was Crohn disease,the most clinical manifestations were abdominal pain,diarrhea,hematochezia and melena,the characteristics of imageological examination were small bowel wall thickening,mesenteric lymph node enlargement and small bowel lumenre.The detection rate of enteroscopy and capsule endoscopy were 26.83%and 8.67%respectively,the common ulcer sites were ileum,ileocecal junction and jejunum,the main endoscopic characteristics of ulcer were irregular appearance,longitudinal,annular and segmental,the main pathological changes were mucosal chronic inflammation and inflammatory cells infiltration.Conclusion:The etiology of small intestinal ulcers is complex,and its clinical characteristics lacks specificity.The enteroscopy and capsule endoscopy are helpful for the diagnosis of small intestinal ulcer,but the endoscopic findings often overlap,pathological biopsy still has certain limitations in the diagnosis of the disease,we should further explore CT and other auxiliary examination in the diagnosis and differential diagnosis of small intestinal ulcer.
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维普
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