1、 炎症性肠病的诊治进展湘雅三医院消化内科 王晓艳 教授Case 1ID/CC: A 21-year-old male presents with abdominal pain for 3 years. HPI: He also complain of diarrhea, fistula, weight loss, stricture and was admitted to hospital for 7 times. One year before he was diagnosed as Crohns Disease(A2, L3, B2p).PE: VS: fever (T:38.3), th
2、in and pale (secondary to anemia); Heart and lung are normal; abdomen soft with right lower quadrant tenderness, visible peristalsis; Perianal fistula.Labs: ESR and CRP elevated. Blood routing, LFT, SPS are normal.Imaging: Colonoscope examination: Crohns Disease? Pathological examination: chronic in
3、flamation in mucose and submucosa.Case 1Colonoscope examinationCase 1CTE imaginingRecord of management: n 1 year agao, 5-ASA( 1 year) and corticosteroids (2 Mon.) were used, which can relieve the symptom. While after withdraw corticosteroids, the fever and abdominal pain became worse.n 4 months ago,
4、 IFX and azathioprine were used for the patient, and his symptoms had been relieved for 15 days to 20 days after IFX injection, then all the symptom will be worsen. Now he found the visible peristalsis occasionally, and the fistula havent be improved. Question: Whats the further treatment for this p
5、atient? Can we draw a conclusion that the fistula hasnt response to IFX? And how to cure the fistula? Can we use IFX every 2-3 weeks after IFX inducing treatment? If it can be done, could the patient get better effect after giving IFX every 2-3 weeks.主要内容一、炎症性肠病的概述1二、溃疡性结肠炎的概述2三、溃疡性结肠炎的诊治3四、克罗恩病的概述4五、克罗恩病的诊治5概 述炎症性肠病（ Inflammatory Bowel Disease, IBD) ：病因不清的慢性肠道炎症，包括溃疡性结肠炎（ ulcerative colitis, UC)和克罗恩（ Crohns disease, CD)。Increasing number of IBD Cases from 1989-2007UC CD临床表现：腹泻、腹痛、便血、里急后重，全身及肠外表现结肠镜：直肠开始向上，弥漫分布，连续病变粘膜活检：病变主要累及粘膜层及粘膜下层溃疡性结肠炎（ UC）
