溃疡性结肠炎----外科治疗及并发症课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,溃疡性结肠炎,外科治疗及并发症,河北医科大学第三医院结直肠肛门外科,河北省大肠肛门病研究中心,赵士彭,溃疡性结肠炎,1,发病情况,在欧美国家发病率高,4-6/100000,在我国发病率有升高,趋势,最近10年报告的病例数目,是前10年38倍,(太原全国慢性非感染性肠道疾病,学术研讨会),化天形死,发病情况,2,临床症状,消化系统症状,腹泻黏液脓血便,常有里急后重,腹痛左下腹、下腹,腹痛一便意一便后缓解,腹胀等,身症状,发热(38C);重症者有中毒症状,多伴有营养消耗性表现,肠外表现,关节炎、口腔溃疡、强直性脊柱炎(HLA-B27),化天形死,临床症状,3,内镜检查,内镜检查表现,弥漫性充血、水肿、糜烂、浅溃疡,*细颗粒状、脆性增加,炎性息肉,中毒性巨结肠是内镜绝对禁忌症,化天形死,内镜检查,4,男25岁,型场性结肠炎,河北省关形力厉研究中,男25岁,型场性结肠炎,5,女岁重型溃疡性结肠炎病史,河北沙关门研完中,女岁重型溃疡性结肠炎病史,6,游游米,北省大肠肛门病研究中心,游游米,7,Severe ulcerative colitis with pseudopolyps,Figure 4-4.Severe ulcerative colitis with pseudopolyps.In addition to severe mucosal,ulceration and inflammation,chronic ulcerative colitis is often associated with the,formation of pseudopolyps,which represent islands of regenerating mucosa and,exuberant inflammation amidst diffuse mucosal destruction.Pseudopolyps have no,malignant potential,Severe ulcerative colitis with,8,X线检查-钡剂灌肠,急性期,黏膜粗大紊乱,肠壁边缘毛刺状或锯齿,状,后期,(椭)圆形充盈缺损,肠管呈铅管征,化天形死,X线检查-钡剂灌肠,9,Severe ulcerative colitis,Figure 4-6 Radiographic appearance of severe ulcerative colitis.This single-contrast barium enema,demonstrates the typical ragged and ulcerative appearance of the mucosa in active ulcerative colitis,Characteristic collar-button or undermining ulcers,general,barium enema and,colonoscopy should be avoided in fulminant ulcerative colitis because of the possibility of precipitating,可北台关肠/7病研兜中心,Severe ulcerative colitis,10,溃疡性结肠炎-外科治疗及并发症课件,11,溃疡性结肠炎-外科治疗及并发症课件,12,溃疡性结肠炎-外科治疗及并发症课件,13,溃疡性结肠炎-外科治疗及并发症课件,14,溃疡性结肠炎-外科治疗及并发症课件,15,溃疡性结肠炎-外科治疗及并发症课件,16,溃疡性结肠炎-外科治疗及并发症课件,17,溃疡性结肠炎-外科治疗及并发症课件,18,溃疡性结肠炎-外科治疗及并发症课件,19,溃疡性结肠炎-外科治疗及并发症课件,20,溃疡性结肠炎-外科治疗及并发症课件,21,溃疡性结肠炎-外科治疗及并发症课件,22,溃疡性结肠炎-外科治疗及并发症课件,23,溃疡性结肠炎-外科治疗及并发症课件,24,溃疡性结肠炎-外科治疗及并发症课件,25,溃疡性结肠炎-外科治疗及并发症课件,26,溃疡性结肠炎-外科治疗及并发症课件,27,溃疡性结肠炎-外科治疗及并发症课件,28,溃疡性结肠炎-外科治疗及并发症课件,29,溃疡性结肠炎-外科治疗及并发症课件,30,溃疡性结肠炎-外科治疗及并发症课件,31,溃疡性结肠炎-外科治疗及并发症课件,32,溃疡性结肠炎-外科治疗及并发症课件,33,溃疡性结肠炎-外科治疗及并发症课件,34,溃疡性结肠炎-外科治疗及并发症课件,35,溃疡性结肠炎-外科治疗及并发症课件,36,溃疡性结肠炎-外科治疗及并发症课件,37,溃疡性结肠炎-外科治疗及并发症课件,38,溃疡性结肠炎-外科治疗及并发症课件,39,溃疡性结肠炎-外科治疗及并发症课件,40,溃疡性结肠炎-外科治疗及并发症课件,41,溃疡性结肠炎-外科治疗及并发症课件,42,溃疡性结肠炎-外科治疗及并发症课件,43,溃疡性结肠炎-外科治疗及并发症课件,44,溃疡性结肠炎-外科治疗及并发症课件,45,溃疡性结肠炎-外科治疗及并发症课件,46,溃疡性结肠炎-外科治疗及并发症课件,47,