本文選題：嗜酸性粒細(xì)胞性胃腸炎 + 診斷　； 參考：《蘭州大學(xué)》2014年碩士論文

【摘要】：目的：探討嗜酸粒細(xì)胞性胃腸炎的臨床特點、診斷標(biāo)準(zhǔn)、鑒別診斷、治療方法,以提高嗜酸粒細(xì)胞性胃腸炎的診療水平。 方法：回顧性分析1例嗜酸粒細(xì)胞性胃腸炎患者的病例資料,結(jié)合復(fù)習(xí)相關(guān)文獻(xiàn)進(jìn)行總結(jié)。 資料：一中年男性患者,進(jìn)行性腹脹20天,入院前外院示白細(xì)胞及嗜酸性粒細(xì)胞增高,轉(zhuǎn)氨酶升高,B超提示有腹水,行腹腔穿刺術(shù),抽出血性腹水,離心涂片見多量嗜酸性粒細(xì)胞、紅細(xì)胞,多量間皮細(xì)胞,給予對癥治療,癥狀無緩解,病情無好轉(zhuǎn)。 干預(yù)措施：行各項常規(guī)檢查、胸部正位片、腹部CT、骨髓穿刺、腹腔穿刺、胃鏡、腸鏡等檢查及病理學(xué)檢查以明確診斷,并給予利尿、營養(yǎng)支持等對癥治療,診斷明確后給予潑尼松35mg/日,此后逐漸減量,5周后停用。 結(jié)果：患者腹脹,病理學(xué)診斷：(食管)鱗狀上皮增生伴非典型增生(輕度)；(胃竇)粘膜慢性炎癥；(十二指腸)粘膜慢性炎癥,有多量淋巴細(xì)胞浸潤、漿細(xì)胞及少量中性粒細(xì)胞、嗜酸性粒細(xì)胞浸潤；(結(jié)腸)慢性炎癥(粘膜),少量嗜酸性粒細(xì)胞浸潤。無胃腸道以外器官嗜酸性粒細(xì)胞浸潤并除外其他引起嗜酸性粒細(xì)胞浸潤的疾病。診斷為嗜酸粒細(xì)胞性胃腸炎。 結(jié)論：對于腹水患者,先從常見病開始積極尋找原因,但不要忽略諸如“嗜酸粒細(xì)胞性胃腸炎”這類少見病、罕見病的可能。嗜酸粒細(xì)胞性胃腸炎常用激素治療有效,要對該病提高認(rèn)識,減少誤診及漏診。
[Abstract]:Objective: to investigate the clinical features, diagnostic criteria, differential diagnosis and treatment of eosinophilic gastroenteritis (eosinophilic gastroenteritis).Methods: a case of eosinophilic gastroenteritis was analyzed retrospectively.Data: a middle-aged male patient with progressive abdominal distension for 20 days showed increased leukocyte and eosinophil and elevated aminotransferase before admission. B-mode ultrasound showed ascites, abdominal puncture was performed, and hemorrhagic ascites were drawn.Many eosinophils, erythrocytes and mesothelial cells were found in centrifuge smears.Intervention measures: routine examination, chest radiography, abdominal CT, bone marrow puncture, abdominal puncture, gastroscopy, enteroscopy and pathological examination were performed to make a definite diagnosis, and diuretic, nutritional support and other symptomatic treatment were given.Prednisone 35mg/ was given after diagnosis and was gradually reduced for 5 weeks.Results: in the patients with abdominal distension, pathological diagnosis showed that the squamous epithelium hyperplasia of the W (esophagus) accompanied with atypical hyperplasia (mild antrum), chronic inflammation of mucosal mucosa (duodenum), multiple lymphocytic infiltration, plasma cells and a small amount of neutrophils.Eosinophils infiltrate (colon) chronic inflammation (mucous membrane, a small amount of eosinophil infiltration.There is no eosinophil infiltration in organs outside the gastrointestinal tract except other diseases that cause eosinophil infiltration.Eosinophil gastroenteritis was diagnosed.Conclusion: for ascites patients, we should start with common diseases, but we should not ignore the possibility of rare diseases such as eosinophil gastroenteritis.Eosinophil gastroenteritis commonly used hormone treatment is effective, to improve the understanding of the disease, reduce misdiagnosis and missed diagnosis.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R57

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