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目的探讨溃疡性结肠炎(UC)和克罗恩病(CD)的诊断和治疗方法。方法回顾性分析1985～2004年的135例符合中华医学会消化病分会制定的炎症性肠病诊断治疗规范标准的病人的临床、肠镜及治疗方法和效果。结果31例CD主要临床症状为糊状腹泻,腹痛多位于脐周或右下腹,内镜下主要表现为节段性、非对称性的黏膜炎症,阿弗他溃疡。104例UC主要表现为反复发作的黏液脓血便,腹痛多位于下腹和左侧,内镜下主要表现为多发性浅表溃疡、弥漫性充血糜烂、假息肉。UC结肠镜确诊率为100%,但CD结肠镜确诊率仅为41.9%。UC内外科治疗完全缓解率33.6%,有效率82.7%;CD完全缓解率为22.6%,有效率为64.5%,UC的治疗有效率明显高于CD(P<0.05)。结论结肠镜是诊断UC的最有效方法,CD的诊断须依靠临床、内镜、X线及手术探查资料进行综合评价。合理的内科治疗和选择性外科治疗可提高IBD治疗效果。
Objective To investigate the diagnosis and treatment of ulcerative colitis (UC) and Crohn’s disease (CD). Methods Retrospective analysis of clinical, colonoscopy and treatment methods and results of 135 cases from 1985 to 2004 in line with the diagnostic criteria for diagnosis and treatment of inflammatory bowel disease developed by the Chinese Medical Association digestive disease branch. Results The main clinical symptoms of 31 cases were pasty diarrhea. Abdominal pain was mostly located on the umbilical or right lower abdomen. The endoscopic findings were segmental and asymmetric mucosal inflammation and aphthous ulcer. 104 cases of UC mainly manifested as recurrent mucus pus and blood stool, abdominal pain and more in the lower abdomen and left, endoscopic mainly for multiple superficial ulcers, diffuse erosion and erosion, false polyps. The diagnosis of UC colonoscopy was 100%, but the diagnosis of CD colonoscopy was only 41.9%. The complete remission rate of UC was 33.6%, the effective rate was 82.7%. The CD remission rate was 22.6% and the effective rate was 64.5%. The effective rate of UC was significantly higher than that of CD (P <0.05). Conclusion Colonoscopy is the most effective method for the diagnosis of UC. The diagnosis of CD depends on the clinical, endoscopic, X-ray and surgical exploration data for comprehensive evaluation. Reasonable medical treatment and selective surgical treatment can improve IBD treatment.