本文選題：末端回腸潰瘍　切入點：腸鏡　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究背景:回腸末端潰瘍是回盲部的好發(fā)疾病之一,它的發(fā)病機制仍未明確,已有研究表明腸道粘膜的異常免疫反應(yīng)在其發(fā)病中發(fā)揮著重要的作用;也有人認(rèn)為是彎曲桿菌感染所致。隨著內(nèi)鏡技術(shù)的不斷進(jìn)步,該病的檢出率正在逐年增加,但由于該部位起病具有隱匿性,起病初期患者的臨床癥狀和體征往往不明顯,因此早期診斷較為困難。目的:通過收集2012年5月-2016年4月于我院進(jìn)行腸鏡檢查并診斷為回腸末端潰瘍的患者,回顧性分析末端回腸潰瘍的發(fā)病率、年齡分布、性別比及內(nèi)鏡下潰瘍特點,增加對回腸末端潰瘍性病變的認(rèn)識。方法:通過收集于我院進(jìn)行腸鏡檢查并診斷為回腸末端潰瘍的病患106例,系統(tǒng)記錄其性別、年齡、內(nèi)鏡下表現(xiàn)及組織病理結(jié)果等,然后進(jìn)行對比研究和統(tǒng)計分析得出結(jié)論。結(jié)果:總檢查人數(shù)7452為人,診斷為回腸末端潰瘍病變的患者106例,占總檢查人數(shù)的1.4%。男性59例,占總檢查人數(shù)的55.7%,女性47例,占總檢查人數(shù)的44.3%。其中10-19歲4例,占總?cè)藬?shù)的3.8%;20-29歲6例,占總?cè)藬?shù)的5.7%;30-39歲24例,占總?cè)藬?shù)的22.6%;40-49歲22例,占總?cè)藬?shù)的20.7%;50-59歲21例,占總?cè)藬?shù)的19.8%;60-69歲19例,占總?cè)藬?shù)的17.9%;70-79歲7例,占總?cè)藬?shù)的6.6%;80歲3例,占總?cè)藬?shù)的2.8%。鏡下表現(xiàn):(1)潰瘍數(shù)目:多發(fā)的潰瘍55例,單發(fā)的潰瘍51例;(2)潰瘍形態(tài):類圓形潰瘍71例,不規(guī)則潰瘍13例,口瘡樣潰瘍8例,巨大潰瘍性腫物7例,縱形裂隙樣潰瘍:5例,地圖樣潰瘍2例;(3)伴隨情況:單純潰瘍36例,22例伴有回盲瓣炎,16例伴有息肉,14例伴有淋巴濾泡增生,8例伴有結(jié)腸炎,4例伴有直腸炎,3例伴有回盲瓣憩室,2例伴有結(jié)腸憩室,1例為結(jié)腸癌術(shù)后。組織病理檢查結(jié)果:慢性非特異性炎癥88例;潰瘍性結(jié)腸炎6例;結(jié)腸癌3例;腸結(jié)核3例;高級別內(nèi)瘤變2例;低級別內(nèi)瘤變1例;克羅恩病1例;T細(xì)胞淋巴瘤1例;白塞病1例。結(jié)論:本研究發(fā)現(xiàn)回腸末端潰瘍的發(fā)生率為1.4%左右,30-60歲檢出率最多,男女的發(fā)病率一般無明顯區(qū)別;鏡下以單發(fā)或者多發(fā)的類圓形潰瘍比較多見,組織病理結(jié)果主要為粘膜組織慢性炎,預(yù)后較好,少有結(jié)腸癌、惡性淋巴瘤等惡性疾病。由于多數(shù)病因診斷困難,仍需進(jìn)一步深入研究。
[Abstract]:Background: ileal ulcer is one of the primary ileocecal disease, its pathogenesis is not clear, studies have shown that the abnormal immune response of intestinal mucosa plays an important role in its pathogenesis; some people think that is caused by Campylobacter infection. With the development of endoscopic technology, the disease detection the rate is increasing year by year, but because of the location of onset with occult onset, clinical symptoms and signs are not obvious, so early diagnosis is difficult. Objective: through collecting the May 2012 -2016 year in April in our hospital were diagnosed as intestinal endoscopy and ileal ulcer were analyzed retrospectively the incidence of ulcer in the terminal ileum rate, age distribution, sex ratio and endoscopic features of ulcer, increase awareness of the ileal ulcer lesions. Methods: collected in our hospital and diagnosed with terminal ileum colonoscopy 婧冪枴鐨勭梾鎮(zhèn)，

本文編號：1675142