虚血性大腸炎46例の臨床的検討 Clinical Study on Forty-six Cases of Ischemic Colitis

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当院で虚血性大腸炎と診断した46例を検討した.男性18例,女性28例で,平均年齢は52.8歳と比較的若かった.腹痛,下痢,下血をすべて認めた症例は78.3%と高率であった.基礎疾患を有したのは26.1%と少なく,便通異常を認めたのは65.2%で,便秘症がその内半数以上を占めていた.再発例は2例であった.病変はすべて左側結腸に認め,S状結腸から下行結腸にわたるものが34.8%と最も多かった.内視鏡所見から軽度,中等度,高度に分類するとそれぞれ11例,23例,12例で,三群を比較すると高度症例では有意に来院までの時間が短く,血液検査における炎症反応陽性率が高かった.入院加療したのは22例(中等度10例,高度全例)であった.すべて一過性型で保存的治療にて軽快し,1ヵ月後の内視鏡検査では全例正常粘膜に復していた.発症早期の内視鏡検査による重症度診断は,予後の推測,治療および経過観察の上で重要と思われた.

We studied clinical features of 46 patients with ischemic colitis, treated in our hospital from November 1999 to October 2001. The average age was 52.8 years old, comparatively younger than that of other previous reports. Typical symptoms of sudden abdominal pain, diarrhea, and hematochezia were recognized in 78.3 % cases. Arteriosclerotic diseases of hypertension, diabetes mellitus and hyperlipidemia were found in 26.1% patients. Thirty patients had complaints of bowel habits, especially 17 constipation. Recurrence was recognized in two cases. Ischemic changes were noticed in the left-sided colon of all patients, especially from the sigmoid to the descending colon. The cases were classified into three groups of mild, moderate, and severe ischemic changes, endoscopically. The number of patients with mild colitis was 11, moderate 23, and severe 12. Comparison of the three groups showed that the positive rate of inflammatory reactions on blood and chemical analysis was higher, and the duration from the onset to visiting our hospital was shorter, in the severe group, significantly. Twenty-two patients admitted to the hospital for 7.ldays on the average. All of our cases were transient types. Endoscopical changes of all cases disappeared one month later. It was thought to be important to perform colonoscopy as soon as possible after the onset, for diagnosis, choice of treatment, and follow-up.

収録刊行物

  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 55(6), 307-312, 2002-06-01

    The Japan Society of Coloproctology

参考文献:  16件中 1-16件 を表示

被引用文献:  2件中 1-2件 を表示

各種コード

  • NII論文ID(NAID)
    10008675085
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    ENG
  • 資料種別
    NOT
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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