内科学-溃疡性结肠炎(本专皆可用)教学内容教学课件

溃疡性结肠炎UlcerativecolitisValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL大洞空腸系膜升钻乙洁腾南尾在大的大都份问的右Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、概述非特异性溃疡性结肠炎,是一种病因不明的直肠和结肠炎性疾病病变限于大肠黏膜与黏膜下层临床表现:腹泻、黏液脓血便、腹痛■可发生在任何年龄,多见于20-40岁我国少见,且病情一般较轻Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL二、病因和发病机制感染因素:某些大肠杆菌释放损伤肠黏膜的物质遗传因素免疫因素环境因素Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、病理病变位于大肠结肠,呈连续性非节段分布。直肠多数扩展乙状结肠降结肠横结肠Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、病理早期粘膜弥漫性炎症,水肿、充血与灶性出血,粘膜面呈弥漫性细颗粒状,组织变脆,触之易出血。■粘膜与粘膜下层有淋巴细胞、浆细胞、嗜酸及中性粒细胞侵润。Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病理肠腺隐窝底部聚集大量中性粒细胞,形成小的隐窝脓肿隐窝脓肿破溃融合形成浅小溃疡,并还渐融合形成大的不规则溃疡。Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、病理结肠炎症在反复发作的慢性过程中,大量新生肉芽组织granulation增生proliferation出现炎性息肉Inflammatorypolyp。Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病理由于溃疡愈合而癜痕形成,结肠变形缩短、结肠袋colonichaustra消失,肠腔变窄。■少数患者有结肠癌变Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL溃性结肠炎48岁。直肠和橫结肠粘膜女,42岁。循腔进镜至结肠分别可见弥漫性充血水肿、点脾曲,可见直肠、乙状结肠片状糜烂溃疡,覆污苔和脓性降结肠弥漫性充血水肿,廨分泌物,渗血,脆性增加。烂溃疡。表面覆白苔脓液病理结果:1.溃疡性结肠炎2.腺瘤型息肉,伴慢性炎Valadononry.chAsposeslidesforNET4odi