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目的:探讨X线对克隆病的诊断要点,并分析其误诊原因.方法:26例患者进行结肠和小肠双对比造影,男性14例,女性12例,平均年龄42岁.病理诊断为克隆病17例.X线表现包括:(1)纵行龛影,(2)卵石征,(3)偏心性狭窄,(4)病变节段性分布,这四种表现为克隆病的主要征象,(5)其他不典型表现.结果:根据X线表现将克隆病分为:(1)典型表现:具有三种主要征象,有5例(29.41%);(2)较典型表现:具有两种主要征象,有3例(17.56%);(3)不典型表现:只有一种主要征象,有9例(52.90%).X线将其他病变误诊为克隆病的9例患者中,8例(88.89%)为不典型表现,误诊的主要原因有肠结核病变的节段性分布,淋巴瘤和缺血性肠病的纵行龛影,溃疡性结肠炎的卵石征等.结论:出现三种主要征象,应首先考虑克隆病的诊断,出现两种主要征象,应疑诊克隆病.
Objective: To explore the diagnostic points of X-ray on Crohn’s disease and to analyze its causes of misdiagnosis.Methods: 26 cases of patients underwent double-contrast colonography and small bowel contrast imaging, 14 males and 12 females, mean age 42 years old.Pathological diagnosis of Crohn’s disease 17 Examples of X-ray manifestations include: (1) longitudinal kennel, (2) pebble sign, (3) eccentric stenosis, (4) segmental lesion distribution, which are the main signs of Crohn’s disease, (5 ) Other atypical manifestations.Results: According to the X-ray findings, the Crohn’s disease was divided into: (1) typical manifestations: there were three main signs, 5 cases (29.41%); (2) more typical manifestations: there were two main signs , And 3 cases (17.56%). (3) Atypical manifestations: there was only one major symptom in 9 cases (52.90%). Of the 9 patients with X-ray misdiagnosed as Crohn’s disease, 8 (88.89% ) Were not typical manifestations, the main reason for misdiagnosis was segmental distribution of intestinal tuberculosis, lymphoma and ischemic bowel disease longitudinal niche, ulcerative colitis sclera sign, etc. Conclusion: There are three main signs , Should first consider the diagnosis of Crohn’s disease, there are two main signs, should be suspected Crohn’s disease.