本文關(guān)鍵詞： 潰瘍性結(jié)腸炎 臨床特征 內(nèi)鏡 病理組織學　出處：《延安大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:回顧性統(tǒng)計分析2011年1月至2016年12月于延安大學附屬醫(yī)院消化內(nèi)科住院的潰瘍性結(jié)腸炎(UC)患者的臨床、病理資料,總結(jié)分析其臨床特征、內(nèi)鏡所見、病理組織學檢查結(jié)果及用藥方案。方法:應用病案瀏覽系統(tǒng)檢索于2011年1月至2016年12月間在延安大學附屬醫(yī)院消化內(nèi)科住院確診為潰瘍性結(jié)腸炎患者的資料,刪除資料不完整者,共110例(同一患者1年多次住院只計1次)。自制統(tǒng)計表,其內(nèi)容包括一般資料、臨床表現(xiàn)、并發(fā)癥、腸鏡所見、病理組織學檢查結(jié)果及用藥方案,使用SPSS20.0軟件包進行統(tǒng)計學處理。年齡用平均數(shù)(x±s)表示,計數(shù)資料用構(gòu)成比描述,組間比較用卡方檢驗。結(jié)果:1.潰瘍性結(jié)腸炎患者男女比例為1.04:1;發(fā)病年齡分布在22~81歲,平均發(fā)病年齡在45±0.5歲。發(fā)病高峰年齡在50~59歲,病程為數(shù)天到20余年。2.不同臨床類型在性別、不同年齡組、病情嚴重程度、病變范圍構(gòu)成比之間無統(tǒng)計學意義;在發(fā)熱、貧血的癥狀之間有統(tǒng)計學意義(P0.05)。3.不同病情程度在性別、年齡組構(gòu)成比之間無統(tǒng)計學意義;在病變范圍構(gòu)成比之間有統(tǒng)計學意義(P0.05),在貧血的癥狀上有統(tǒng)計學意義(P0.05)。4.不同病變范圍在性別構(gòu)成、年齡組、臨床表現(xiàn)的構(gòu)成比之間無統(tǒng)計學意義(P0.05)。5.不同臨床表現(xiàn)在性別構(gòu)成方面無顯著差異;腹脹、發(fā)熱的癥狀在不同年齡組構(gòu)成比之間有統(tǒng)計學意義(P0.05)。6.飲食因素、吸煙與潰瘍性結(jié)腸炎的發(fā)病密切相關(guān)。7.腸鏡所見主要以糜爛、潰瘍、血管紋理模糊、充血水腫為主;病理組織學檢查結(jié)果提示不典型增生在不同病變部位、不同病情構(gòu)成比之間有統(tǒng)計學意義(P0.05)。8.治療情況:輕中度者使用5-氨基水楊酸類制劑的比例高,病情為重度者應用糖皮質(zhì)激素的比例高,行手術(shù)治療的僅有2例。結(jié)論:1.潰瘍性結(jié)腸炎患者男女比例無明顯差異;發(fā)病高峰年齡在50~59歲,平均發(fā)病年齡在45±0.5歲。病程為數(shù)天到20余年。2.貧血在初發(fā)型、重度患者中多見,發(fā)熱在老年患者及慢性復發(fā)型、慢性持續(xù)型中多見。3.潰瘍性結(jié)腸炎的發(fā)病與飲食及不吸煙關(guān)系密切。4.腸鏡所見主要以糜爛、潰瘍、血管紋理模糊、充血水腫為主;不典型增生好發(fā)于直腸及重度潰瘍性結(jié)腸炎患者。5.治療主要采用藥物保守治療。輕中度患者多使用氨基水楊酸類制劑,重度患者多采用糖皮質(zhì)激素治療。
[Abstract]:Objective: to analyze retrospectively the clinical and pathological data of patients with ulcerative colitis (UC) hospitalized in the Department of Digestive Medicine, affiliated Hospital of Yan'an University from January 2011 to December 2016. The clinical features and endoscopic findings were summarized and analyzed. Results of histopathological examination and medication scheme. Methods:. The medical record browsing system was used to search the data of the patients with ulcerative colitis who were diagnosed as ulcerative colitis from January 2011 to December 2016 in the Department of Gastroenterology, affiliated Hospital of Yan'an University. There were 110 cases with incomplete data removed (the same patient was hospitalized only once a year.) Self-made statistical tables were made, including general information, clinical manifestations, complications, and colonoscopy. The results of histopathological examination and medication scheme were analyzed by SPSS20.0 software package. The age was expressed by the mean value (x 鹵s), and the counting data were described by composition ratio. Results: 1. The ratio of male and female patients with ulcerative colitis was 1.04: 1; The age of onset was 22 ~ 81 years old, the average age was 45 鹵0.5 years old, the peak age was 50 ~ 59 years old, the course of disease ranged from several days to more than 20 years .2. different clinical types were in sex. In different age groups, there was no significant difference between the severity of the disease and the ratio of pathological range. There was significant difference between the symptoms of fever and anemia (P 0.05). There were significant differences in the range of lesions between P0.05 and anemia symptoms P0.05. 4. Different lesion areas in the gender composition, age group. There was no significant difference in the composition ratio of clinical manifestations between the two groups (P 0.05. 5). There was no significant difference in sex composition among different clinical manifestations. Symptoms of abdominal distension and fever in different age groups have statistical significance between the composition ratio of P0.05. 6. dietary factors, smoking and ulcerative colitis is closely related to the incidence of .7.The colonoscopy mainly showed erosion. Ulcer, blurred vascular texture, hyperemia and edema; Histopathological examination showed that atypical hyperplasia was located in different lesions. There was significant difference between different disease constitution ratio (P0.05). Treatment: the proportion of 5-aminosalicylic acid preparation was high in mild and moderate patients, and the proportion of glucocorticoid was high in patients with severe disease. Only 2 cases were treated surgically. Conclusion 1. There is no significant difference between male and female patients with ulcerative colitis. The peak age of onset was 50 ~ 59 years old, the average age of onset was 45 鹵0.5 years. The course of disease was from several days to more than 20 years. The incidence of ulcerative colitis was closely related to diet and non-smoking. Hyperemia and edema; Atypical hyperplasia occurred in rectum and severe ulcerative colitis patients. 5. Drug conservative therapy was used in the treatment. Aminosalicylic acid preparations were used in mild to moderate patients and glucocorticoids were used in severe patients.
【學位授予單位】：延安大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R574.62

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