孤立性右半结肠缺血性结肠炎预后分析-欢迎访问中华老年多器官疾病.DOC

·临床研究· 孤立性右半结肠缺血性结肠炎预后分析? 廖 亮1，王 薇2，许 乐2，吴本俨1* （1解放军总医院南楼消化科，北京 100853；2卫生部(卫计委？？？)北京医院消化内科，北京 100730） 【摘 要】背景 总的来说，缺血性结肠炎（IC）有比较好的预后，不过当缺血仅仅孤立影响右半结肠时，预后可能往往不好。目的 本研究的目的是对比缺血仅发生在右半结肠与缺血发生在结肠其他部位患者的临床结局。方法 回顾性总结分析170例住院的IC患者，并将其分为两组：孤立性右半结肠缺血（IRCI）患者为一组，另一组为除孤立性右半结肠缺血（non-IRCI）外的IC患者。所有的患者均经过结肠镜检查确诊。结果 共采集170例经过结肠镜检查确诊的IC患者。其中36例（21.18%）为IRCI，其中61.11%的IRCI患者经治疗后病情仍有恶化，而仅仅8.96%的non-IRCI患者病情恶化；18例（50.00%）的IRCI患者需要外科手术治疗，而仅7.46%的non-IRCI患者需要手术治疗；IRCI病人死亡率为16.67%，而non-IRCI病人仅2人（1.49%）死亡。结论 总共170例经结肠镜明确诊断的IC患者，其中包括36例（21.18%）病变仅发生在右半结肠的患者。IRCI患者的预后比病变发生在结肠其他区域的患者更差。 【关键词】结肠炎，缺血性；孤立性右半结肠缺血 【中图分类号】 R574.62 【文献标识码】 A 【DOI】 10.11915/j.issn.1671-5403.2015.xx.xxx Prognosis of ischemic colitis that isolated to the right side of the colon LIAO Liang1, WANG Wei2, XU Le2, WU Ben-Yan1* (1Department of Geriatric Gastroenterology, Chinese PLA General Hospital, Beijing 100853, China; 2Department of Gastroenterology, Beijing Hospital, National Health and Family Planning Commission, Beijing 100730, China) 【Abstract】 Background Usually, ischemic colitis has a good outcome, but when ischemia isolated to the right side of the colon, the prognosis may be not so favorable. Objective To compare the prognosis of ischemia isolated to the right side of the colon with those of involving other segments of the colon. Methods A retrospective study was performed on the 170 patients with colon ischemia hospitalized during the interval of 1999 to 2010. They were divided into 2 groups: those with isolated right colon ischemia (IRCI) and those with colon ischemia not involving the right colon in an isolated fashion (non-IRCI). Only the patients with colonoscopy confirmed ischemic colitis were entered into our study. Results A total of 170 cases were enrolled in this study, of which 36(21.18%) were isolated to the right side. Of these IRCI cases, 61.11% had an unfavorable outcome even after treatment, but the percentage was only 8.96% for those with non-ICRI. Eighteen IRCI patien