回盲部炎性包块241例临床特征分析VIP专享VIP免费

生垡逍垡苤查!!!i生!旦筮!!鲞筮!塑堡!i!』旦适!里!!!!!!!!!!i!y!!：!!!盟!：!回盲部炎性包块241例临床特征分析王宁王飙落王新梁树辉韩霜吴开春【摘要】目的探讨回盲部炎性包块病因及其临床特征，提高回盲部炎性包块的诊治水平。方法收集2006年7月至2011年7月收治的回盲部炎性包块病例的一般资料、病史、临床表现、并发症、影像学检查、结肠镜、病理检查及诊断等资料，归纳其临床特征。结果共收集回盲部炎性包块患者241例，其中克罗恩病83例，阑尾炎并周围脓肿79例，肠结核54例，肠道恶性淋巴瘤8例，未明确病因17例。85例患者主要临床表现为腹痛、右下腹包块和发热，其中克罗恩病56例。行手术治疗90例，其中克罗恩病44例，12例以急性阑尾炎并周围脓肿行手术治疗，术后再发回盲部炎性包块，再次病理检查确诊为克罗恩病。病程中并发肠梗阻69例，其中克罗恩病44例。并发肠瘘9例、上消化道溃疡24例、皮肤脓疱疹1例，均为克罗恩病。结论回盲部炎性包块常见病因为克罗恩病。手术切除后再发回盲部炎性包块，或回盲部炎性包块并发肠梗阻和(或)肠外表现时，以克罗恩病多见。【关键词】Crohn病；回肠；肠梗阻；阑尾炎；腹痛Clinicalfeaturesof241ileocecalinflammatorymasspatientsWANGNing，WANGBiao—luo，WANGXin．LIANGShu—hui，HANShuang，WUKai—chun．GastrointestinalDivision5，XijingHospitalofDigestiveDiseases，Xi7an710032，ChinaCorrespondingauthor：WUKai—chun，Email：kaicwu@fmmu．edn．cn【Abstract】ObjectiveToinvestigatetheetiologyandclinicalcharactersofileocecalinflammatorymassandtoimprovethediagnosisandtherapyofileocecalinflammatorymass．MethodsFromJuly2006toJuly2011，thedataofileocecalinflammatorymasscaseswerecollected，includingdiseasehistory，clinicalmanifestations，complications，imagingresults，colonscopyresults，pathologicalresultsanddiagnosis．Theclinicalcharactersweresummarized．ResultsAtotalof241caseswithileocecalinflammatorymasswerecollectedand83casesofthemwereCrohn’sdisease，79caseswereappendicitiswithperiappendicealabscess，54caseswereintestinaltuberculosis，eightcaseswereintestinalmalignantlymphomaand17caseswereundefined．Themainmanifestationsof85patientswereabdominalpain，rightinferiorabdominalmassandfever，amongwhich56patientswereCrohnsdisease．Among90patientswithsurgicaloperation，44patientswereCrohn’sdisease，amongwhich12patientsreceivedoperationbecauseofappendicitiswithperiappendicealabscessatfirstwhilethepathologicalexaminationafteroperationfortherecurrenceofileocecalinflammatorymassesprovedCrohn’sdisease．Duringthecourseofdisease，69caseshadcomplicationsofintestinalobstruction，inwhom44caseswereCrohn’sdisease．Ninecaseshadintestinalfistula，24caseshaduppergastrointestinalulcers，onecasehadimpetigo，andalloftheabovecaseswereCrohn’sdisease．ConclusionsThecommonetiologiesofileocecalinflammatorymasswereCrohn’sdisease．Ileocecalinflammatorymassrecurrenceaftersurgery，ileocecalinflammatorymasscomplicatedwithintestinalobstructionandabentericmanifestationsweremorecommoninCrohn’sdisease．[Keywords]Crohn’sdisease；Ileum；Intestinalobstruction；Appendicitis；AbdominalpainDOI：10．3760／cma．j．issn．0254—1432．2013．02．006作者单位：710032西安，西京消化病医院胃肠五科通信作者：吴开春，Email：kaicwu@fmmu．edu．cn论著万方数据一98一回盲部炎性包块临床较为多见，主要表现为右下腹包块、腹痛、腹泻、便血、发热、右下腹压痛、肠梗阻等，但均非特异性，故误诊率较高。本研究通过分析西京消化病医院诊治的241例回盲部炎性包块病例的临床特征，期望加强临床医师对回盲部炎性包块的认识，提高诊治水平。对象与方法一、病例来源与研究方法采用计算机病案管理系统收集2006年7月至2011年7月...