溃疡性结肠炎的诊疗和治疗培训课件.ppt

1、溃疡性结肠炎的诊疗和溃疡性结肠炎的诊疗和治疗治疗溃疡性结肠炎的诊疗和治疗2溃疡性结肠炎的诊疗和治疗3Endoscopic 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 e

2、xudate.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 Cr

3、ohns 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 a

4、nd a patchy exudate.溃疡性结肠炎的诊疗和治疗4Ulcerative colitis in remission溃疡性结肠炎的诊疗和治疗5溃疡性结肠炎的诊疗和治疗6溃疡性结肠炎的诊疗和治疗7溃疡性结肠炎的诊疗和治疗8Resected colon from patient with ulcerative colitisFigure 4-8.Gross pathologic specimen of resected colon from a patient with severe ulcerative colitis.Inflammation is diffuse and cont

5、inuous,involving the mucosa and extending from the rectum without interruption to the ascending colon.溃疡性结肠炎的诊疗和治疗9溃疡性结肠炎的诊疗和治疗10溃疡性结肠炎的诊疗和治疗11溃疡性结肠炎的诊疗和治疗12溃疡性结肠炎的诊疗和治疗13溃疡性结肠炎的诊疗和治疗14UC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 无无溃疡性结肠炎的诊疗和治疗15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 溃疡性结肠炎的诊疗和治疗16溃疡性结肠炎的诊疗和治疗17溃疡

6、性结肠炎的诊疗和治疗18可选用柳氮磺胺吡啶（可选用柳氮磺胺吡啶（SASPSASP）制剂，每）制剂，每日日34g34g，p op o；5-5-氨基水杨酸（氨基水杨酸（5-ASA5-ASA）制）制剂。远段结肠者可剂。远段结肠者可SASPSASP栓剂栓剂0.51g0.51g，每日，每日2 2次；氢化可的松琥珀酸钠盐灌肠液次；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，或用相次保留灌肠，或用相当剂量的当剂量的5-ASA5-ASA制剂灌肠制剂灌肠，亦可用中药保留灌肠治疗。溃疡性结肠炎的诊疗和治疗19溃疡性结肠炎的诊疗和治疗20溃疡性结肠炎的诊疗和治疗21溃疡性结肠炎的诊疗和治疗23溃疡性结肠炎的诊疗和治疗24溃疡性结肠炎的诊疗和治疗25溃疡性结肠炎的诊疗和治疗26溃疡性结肠炎的诊疗和治疗27*包括巨红细胞症、变性血红蛋白及Heing抗体水平升高。*有红细胞G-6-PD缺乏患者，同样可发生溶血。SASP的不良反应的不良反应溃疡性结肠炎的诊疗和治疗28溃疡性结肠炎的诊疗和治疗29GCS治疗治疗UC和和CD的指征的指征溃疡性结肠炎的诊疗和治疗30溃疡性结肠炎的诊疗和治疗31溃疡性结肠炎的诊疗和治疗32溃疡性结肠炎的诊疗和治疗33溃疡性结肠炎的诊疗和治疗34溃疡性结肠炎的诊疗和治疗35溃疡性结肠炎的诊疗和治疗36