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目的 :探讨急重型克隆病的临床特点及其诊断和治疗。方法 :回顾本院 1995～ 2 0 0 2年经手术、病理证实的 10例急重型克隆病 ,并结合近期文献进行分析。结果 :10例急重型克隆病初诊时全部误漏诊。其中 9例行了外科手术治疗 ,5例行病变肠段切除。 10例病人中 8例缓解出院 ,2例住院期间死亡。 8例均获随访 ,其中 4例无复发 ,2例轻度复发 ,2例已死亡。结论 :急重型克隆病误漏诊的主要原因是对本病认识不足 ,临床上对此病没有高度的警惕性 ;总结出 6点临床特征 ;病变肠段切除是有效的手术方式 ,但仍强调内科保守治疗特别是皮质激素治疗的重要性。
Objective: To investigate the clinical features, diagnosis and treatment of severe Crohn’s disease. Methods: Ten cases of acute severe Crohn’s disease confirmed by operation and pathology in our hospital from 1995 to 2002 were retrospectively analyzed, combined with the recent literatures. Results: All 10 cases of acute severe Crohn’s disease were misdiagnosed when they were newly diagnosed. Among them, 9 cases underwent surgical treatment and 5 cases underwent pathological resection of bowel. 8 of 10 patients were relieved and discharged, and 2 died during hospitalization. All 8 patients were followed up, of which 4 had no recurrence, 2 had mild recurrence and 2 had died. Conclusion: The main reason of misdiagnosis of acute severe Crohn ’s disease is lack of understanding of the disease and no high vigilance on this disease in clinical practice. The clinical features of 6 points are summarized. Lesion of bowel resection is an effective surgical method, but still emphasizes internal medicine The importance of conservative treatment, especially corticosteroid treatment.