溃疡性结肠炎诊断与治疗.ppt

溃疡性结肠炎诊断与治疗;临床症状;内镜检查及X线检查;Endoscopic features of active ulcerative colitis Figure 4-1. Endoscopic features of active ulcerative colitis. Findings include diffusely erythematous, edematous, and granular mucosa with areas of submucosal hemorrhage and, when severe, frank mucopurulent exudate. Inflammation invariably begins in the rectum and extends proximally for varying extents. The chronicity of the process is suggested by the loss of colonic haustrations; otherwise, the endoscopic picture is nonspecific and could be consistent with acute infectious colitis, chronic ulcerative or Crohn`s colitis, or any number of other specific causes of colitis. A, Mild distal ulcerative colitis with diffuse erythema and friability well demarcated from the normal mucosa more proximally is depicted. B, This example shows moderately severe ulcerative colitis with irregular, inflamed, ulcerated mucosa and a patchy exudate.;Ulcerative colitis in remissionFigure 4-2. Ulcerative colitis in remission. The normal vascular pattern is absent and a white scar indicates the site of a previous ulcer.;Severe ulcerative colitisFigure 4-3. Severe ulcerative colitis. The mucosa shows extensive ulceration and diffuse thickening with an inflammatory infiltrate. In contrast to Crohn`s colitis, the ulceration lacks depth.;Chronic ulcerative colitisFigure 4-5. Chronic ulcerative colitis. In long-standing ulcerative colitis, the mucosa has an atrophic and scarred appearance with a blunted vascular pattern. Pseudopolyps are often present.;Severe ulcerative colitis with pseudopolypsFigure 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.;其他辅助检查;临床分型;鉴别诊断;鉴别要点;指标;并发症;轻度溃结处理;中度溃结处理;重度溃结处理;重度溃结治疗;重度溃结治疗;