摘要
目的评价重型溃疡性结肠炎(UC)的临床疗效及治疗转归,寻找提示疗效及预后的相关因素。方法回顾性分析41例住院重型 UC 患者的病例资料。记录临床表现及诊疗经过,对柳氮磺胺吡啶(SASP)/5-氨基水杨酸(5-ASA)、皮质激素、免疫抑制剂等药物疗效进行评价,并对手术病例进行分析。结果重型 UC 患者占同期住院 UC 患者的28.5%(41/144),其中17.1%(7/41)伴肠道外表现;92.7%(38/41)为全结肠型病变,初发型、慢性持续型及慢性复发型分别占36.9%(15/41)、36.9%(15/41)和26.8%(11/41);控制急性发作主要药物为激素,占61.0%(25/41);31例(75.6%)重型 UC 经药物治疗缓解,7例(17.1%)最终手术治疗。发病年龄轻、全结肠病变、低血红蛋白、低血清白蛋白是提示药物疗效差、需手术治疗的相关因素。结论对于重型 UC,除积极系统的药物治疗外,应及时评估药物疗效及手术需求。
Objective To evaluate the clinical outcome of severe ulcerative colitis （UC） and to find the factors related to treatment and outcome. Methods Forty one hospitalized patients with UC during 1988-2004 were retrospectively reviewed. Data were recorded including the onset, symptoms, signs, laboratory, endoscopic, radiologic and pathologic findings, as well as the processes of clinical treatment. The patients who undergone surgery were also analysed. Results Forty one of 144 （28.5%） hospitalized patients were suffered from severe UC, and among them 92.7 % （38/41） had pancolitis. The patients who had first onset, chronic persistent, chronic recurrent type were account for 36.9 % （15/41）, 36.9 % （15/41） and 26.8% （11/41）, respectively. The steroids treatment played the main role in the inducing remission of severe UC （61.0%）. Thirty one cases （75.6%） could be relieved by drug therapy. Seven cases （17.1%） were progressed to have operation. The age of early onset, pancolitis, low hemoglobin and serum albumin levels and need of intravenous steroids treatment were associated with the need of surgery. Conclusions Most of the severe UC patients respond well to the medical therapy, but for some non-responding or steroids depending individuals, after a reasonable duration of treatment, surgery should be considered.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2006年第5期291-294,共4页
Chinese Journal of Digestion
