溃疡性结肠炎的诊断与治疗

1、溃疡性结肠炎的诊断与治疗Endoscopic features of active ulcerative colitisFigure 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

2、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 Crohns colitis, or any number

3、 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.

4、Ulcerative colitis in remissionUC和和CD的病理鉴别要点的病理鉴别要点+ 始终有始终有 +常有常有 +偶有偶有 无无评估溃疡性结肠炎严重性的评估溃疡性结肠炎严重性的标准标准 可选用柳氮磺胺吡啶（可选用柳氮磺胺吡啶（SASPSASP）制剂，每日）制剂，每日34g34g，p op o；5- 5-氨基水杨酸（氨基水杨酸（5-ASA5-ASA）制剂。）制剂。远段结肠者可远段结肠者可SASPSASP栓剂栓剂0.51g0.51g，每日，每日2 2次；次；氢化可的松琥珀酸钠盐灌肠液氢化可的松琥珀酸钠盐灌肠液100200mg100200mg，每晚每晚1 1次保留灌肠，或用相当剂量的次保留灌肠，或用相当剂量的5-ASA5-ASA制剂灌肠制剂灌肠，亦可用中药保留灌肠治疗。* 包括巨红细胞症、变性血红蛋白及Hein