克罗恩病48例临床特点分析

Clinical characteristics analysis in 48 Crohn's disease patients

关键词:  克罗恩病  临床特征  诊断  药物治疗

Key words:  Crohn' s disease  clinical characteristics  diagnosis  drug treatment

摘要:

目的　观察克罗恩病(Crohn' s disease CD)临床特点，提高早期诊断准确率， 改善治疗效果，减少误诊。　方法　收集大连医科大学附属第二医院收治的CD患者48例，男32例，女16例，年龄18～85岁，平均(46.83±4.10)岁。分析患者的临床特点、实验室检查、内镜检查及病理学、影像学检查资料。观察误诊情况及治疗经过。　结果　48例患者中小肠病变12例(25%)、回盲部病变26例(54.16%)、大肠病变10例(20.83%)。48例CD患者中最常见的症状为腹痛44例(91.66%)、腹泻22例(45.83%)。并发腹部包块8例（16.66%)，肠梗阻14例（29.16%)。本组12例(25%)误诊。32例（66.7%)患者采用药物治疗，其余16例因并发症选择手术治疗。　结论　克罗恩病多好发于回盲部，内镜检查、病理学检查是诊断克罗恩病的重要依据，以内科治疗为主，如手术治疗应严格掌握适应证。

Abstract:

Objective　 To increase the early diagnostic accuracy of Crohn's disease (Crohn's diseases, CD), improve the treatment effect, and reduce misdiagnosis.　Methods　 We summarized retrospectively clinical characteristics, laboratory examination, endoscopy and pathology and imaging changes of 48 patients with CD from the second affiliated hospital of Dalian medical university.　Results　 In 48 patients with CD, 32 male and 16 female, age distributed between 18 and 85 years old (46.83±4.10). In all of 48 patients, there were 12 cases (25%) with small intestinal lesions, 26 cases (54.16%) with ileocecal region lesions, 10 cases (20.83%) with colon lesions. The most common symptoms are abdominal pain (44/48, 91.66%), and diarrhea (22/48, 45.83%). There are many complications in CD, of which 14 cases (29.16%) with intestinal obstruction and 8 cases (16.66%) with abdominal mass. There were 12 cases (25%) misdiagnosed. Thirty-two patients had drug treatment.　Conclusion　 Crohn' s disease mostly occur in the ileocecal region. Endoscope and pathology is an important basis for the diagnosis of Crohn's disease. Most case is given priority to medical treatment. Surgical indications should be strictly controlled.