【摘要】：目的探討回盲部病變的臨床特征及診斷治療方案。方法收集2009年9月至2016年3月該院134例回盲部病變患者的一般資料、臨床表現(xiàn)、影像學(xué)檢查、結(jié)腸鏡及病理檢查和診斷等資料,采用回顧性分析方法,歸納其臨床特征。結(jié)果共收集回盲部病變134例,其中回盲部癌36例(26.87%),炎癥性腸病30例(包括潰瘍性結(jié)腸炎和克羅恩病,22.39%),腸結(jié)核26例(19.40%)。其臨床表現(xiàn)主要為腹痛、腹脹、腹瀉、便血等。腸鏡下主要表現(xiàn)為黏膜充血腫脹、紅斑、糜爛、潰瘍及腫塊樣新生物。良性疾病(除回盲部癌及淋巴瘤以外病例)以潰瘍形成伴局部黏膜充血、腫脹為主,回盲部癌則以回盲部新生物多見。影像學(xué)檢查以腹部CT為主,共93例(69.40%)行該檢查。手術(shù)治療49例,術(shù)前診斷錯(cuò)誤7例,誤診率14.28%。結(jié)論回盲部病變總體以良性疾病為主,診療過程復(fù)雜,確診困難,誤診率較高。
[Abstract]:Objective to investigate the clinical features and diagnosis and treatment of ileocecal lesions. Methods from September 2009 to March 2016, 134 patients with ileocecal lesions were collected. The clinical data, clinical manifestation, imaging examination, colonoscopy and pathological examination and diagnosis were collected, and their clinical features were summarized by retrospective analysis. Results 134 cases of ileocecal lesions were collected, including 36 cases of ileocecal carcinoma (26.87%), 30 cases of inflammatory bowel disease (including ulcerative colitis and Crohn's disease, 22.39%), 26 cases of intestinal tuberculosis (19.40%). The main clinical manifestations are abdominal pain, abdominal distension, diarrhea, blood stool and so on. The main manifestations of colonoscopy are congestion, swelling, erythema, erosion, ulcers and tumor-like neoplasm. Benign diseases (except ileocecal carcinoma and lymphoma) were mainly ulcer formation with local mucosal congestion and swelling, while ileocecal carcinoma was more common in ileocecal neoplasm. Abdominal CT was the main imaging examination, which was performed in 93 cases (69.40%). 49 cases were treated by operation, 7 cases were misdiagnosed before operation, the misdiagnosis rate was 14.28%. Conclusion the ileocecal lesions are mainly benign diseases, the diagnosis and treatment process is complicated, the diagnosis is difficult, and the misdiagnosis rate is high.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第二醫(yī)院消化科;
【基金】：重慶市科學(xué)技術(shù)委員會(huì)科技事業(yè)發(fā)展基金資助項(xiàng)目(CSTC2015SHMSZX120047)
【分類號(hào)】：R57

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