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目的总结淋病双球菌性直肠、结肠炎的临床、内镜特征,以提示消化科医师对此疾病的注意。方法回顾经内镜诊断的6例淋病双球菌性直肠、结肠炎患者资料,归纳分析其临床、内镜下表现及病理学、细菌学检查结果。结果淋病双球菌性直肠、结肠炎患者多以肛门搔痒、烧灼感及腹泻为主诉。肠镜下直肠及乙状结肠粘膜均有不同程度水肿、充血,表面附有较多粘液,3例附有脓性分泌物,2例有散在片状出血点及局灶性糜烂及浅表溃疡。病理学检查4例呈慢性炎症改变,2例呈灶性糜烂、坏死,形成浅表溃疡。分泌物涂片革兰氏染色4例阳性,6例均培养出淋病双球菌。结论淋病双球菌性直肠、结肠炎内镜下无特异性改变,但严重者可见有较多脓性分泌物,分泌物涂片革兰氏染色有诊断价值,培养阳性率最高。
Objective To summarize the clinical and endoscopic features of gonococcal rectum and colitis in order to remind gastroenterologists of the disease’s attention. Methods The data of 6 cases of gonococcal rectum and colitis diagnosed by endoscopy were retrospectively analyzed. The clinical, endoscopic and histopathological and bacteriological examination results were summarized. Results gonococcal rectum, colitis patients mostly anal itching, burning and diarrhea as the main complaint. Colonoscopy and sigmoid colon rectal mucosa have varying degrees of edema, congestion, the surface with more mucus, with purulent secretions in 3 cases, 2 cases of scattered flakes and focal erosion and superficial ulcers. Pathological examination showed chronic inflammatory changes in 4 cases, 2 cases of focal erosion, necrosis, the formation of superficial ulcers. Secretion smear Gram stain in 4 cases were positive, 6 cases were gonorrhea gonorrhea. Conclusion There is no specific change of gonococcal rectum and colitis in endoscopy. However, in severe cases, there are more purulent secretions and Gram stain of smear secreted. The positive rate of culture is the highest.