延安大学附属医院溃疡性结肠炎住院患者临床病理特征分析

发布时间：2018-02-06 03:50

本文关键词： 溃疡性结肠炎临床特征内镜病理组织学　出处：《延安大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:回顾性统计分析2011年1月至2016年12月于延安大学附属医院消化内科住院的溃疡性结肠炎(UC)患者的临床、病理资料,总结分析其临床特征、内镜所见、病理组织学检查结果及用药方案。方法:应用病案浏览系统检索于2011年1月至2016年12月间在延安大学附属医院消化内科住院确诊为溃疡性结肠炎患者的资料,删除资料不完整者,共110例(同一患者1年多次住院只计1次)。自制统计表,其内容包括一般资料、临床表现、并发症、肠镜所见、病理组织学检查结果及用药方案,使用SPSS20.0软件包进行统计学处理。年龄用平均数(x±s)表示,计数资料用构成比描述,组间比较用卡方检验。结果:1.溃疡性结肠炎患者男女比例为1.04:1;发病年龄分布在22~81岁,平均发病年龄在45±0.5岁。发病高峰年龄在50~59岁,病程为数天到20余年。2.不同临床类型在性别、不同年龄组、病情严重程度、病变范围构成比之间无统计学意义;在发热、贫血的症状之间有统计学意义(P0.05)。3.不同病情程度在性别、年龄组构成比之间无统计学意义;在病变范围构成比之间有统计学意义(P0.05),在贫血的症状上有统计学意义(P0.05)。4.不同病变范围在性别构成、年龄组、临床表现的构成比之间无统计学意义(P0.05)。5.不同临床表现在性别构成方面无显著差异;腹胀、发热的症状在不同年龄组构成比之间有统计学意义(P0.05)。6.饮食因素、吸烟与溃疡性结肠炎的发病密切相关。7.肠镜所见主要以糜烂、溃疡、血管纹理模糊、充血水肿为主;病理组织学检查结果提示不典型增生在不同病变部位、不同病情构成比之间有统计学意义(P0.05)。8.治疗情况:轻中度者使用5-氨基水杨酸类制剂的比例高,病情为重度者应用糖皮质激素的比例高,行手术治疗的仅有2例。结论:1.溃疡性结肠炎患者男女比例无明显差异;发病高峰年龄在50~59岁,平均发病年龄在45±0.5岁。病程为数天到20余年。2.贫血在初发型、重度患者中多见,发热在老年患者及慢性复发型、慢性持续型中多见。3.溃疡性结肠炎的发病与饮食及不吸烟关系密切。4.肠镜所见主要以糜烂、溃疡、血管纹理模糊、充血水肿为主;不典型增生好发于直肠及重度溃疡性结肠炎患者。5.治疗主要采用药物保守治疗。轻中度患者多使用氨基水杨酸类制剂,重度患者多采用糖皮质激素治疗。
[Abstract]:Objective: to analyze retrospectively the clinical and pathological data of patients with ulcerative colitis (UC) hospitalized in the Department of Digestive Medicine, affiliated Hospital of Yan'an University from January 2011 to December 2016. The clinical features and endoscopic findings were summarized and analyzed. Results of histopathological examination and medication scheme. Methods:. The medical record browsing system was used to search the data of the patients with ulcerative colitis who were diagnosed as ulcerative colitis from January 2011 to December 2016 in the Department of Gastroenterology, affiliated Hospital of Yan'an University. There were 110 cases with incomplete data removed (the same patient was hospitalized only once a year.) Self-made statistical tables were made, including general information, clinical manifestations, complications, and colonoscopy. The results of histopathological examination and medication scheme were analyzed by SPSS20.0 software package. The age was expressed by the mean value (x 卤s), and the counting data were described by composition ratio. Results: 1. The ratio of male and female patients with ulcerative colitis was 1.04: 1; The age of onset was 22 ~ 81 years old, the average age was 45 卤0.5 years old, the peak age was 50 ~ 59 years old, the course of disease ranged from several days to more than 20 years .2. different clinical types were in sex. In different age groups, there was no significant difference between the severity of the disease and the ratio of pathological range. There was significant difference between the symptoms of fever and anemia (P 0.05). There were significant differences in the range of lesions between P0.05 and anemia symptoms P0.05. 4. Different lesion areas in the gender composition, age group. There was no significant difference in the composition ratio of clinical manifestations between the two groups (P 0.05. 5). There was no significant difference in sex composition among different clinical manifestations. Symptoms of abdominal distension and fever in different age groups have statistical significance between the composition ratio of P0.05. 6. dietary factors, smoking and ulcerative colitis is closely related to the incidence of .7.The colonoscopy mainly showed erosion. Ulcer, blurred vascular texture, hyperemia and edema; Histopathological examination showed that atypical hyperplasia was located in different lesions. There was significant difference between different disease constitution ratio (P0.05). Treatment: the proportion of 5-aminosalicylic acid preparation was high in mild and moderate patients, and the proportion of glucocorticoid was high in patients with severe disease. Only 2 cases were treated surgically. Conclusion 1. There is no significant difference between male and female patients with ulcerative colitis. The peak age of onset was 50 ~ 59 years old, the average age of onset was 45 卤0.5 years. The course of disease was from several days to more than 20 years. The incidence of ulcerative colitis was closely related to diet and non-smoking. Hyperemia and edema; Atypical hyperplasia occurred in rectum and severe ulcerative colitis patients. 5. Drug conservative therapy was used in the treatment. Aminosalicylic acid preparations were used in mild to moderate patients and glucocorticoids were used in severe patients.
【学位授予单位】：延安大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574.62

【参考文献】