| Objective To understand the onset condition,clinical,endoscopy, pathology,and treatment characteristics of hospitalized patients with inflammatory bowel disease(IBD)in Kunming,we had retrospectively analyzed inpatients with IBD in the recent 10 years in Kunming.Methods The detail data of 430 cases of IBD,including 379 cases ulcerative colitis(UC)and 51 cases Crohn' s disease(CD),were obtained from seven large general hospital of Zunming from January of 1998 to March of 2007 which are consistent with inflammatory bowel disease(IBD)diagnostic and treatment criteria established in the digestion disease institute branch conference of China in 2007.The clinical,pathology,treatment characteristics corresponding endoscopy and pathology in IBD patients are analyzed.Results1.The onset condition:379 cases ulcerative colitis(UC)and 51 cases Crohn's disease(CD)were included.And the hospitalized patients with IBD have increased year on year in the recent 10 years in Kunming.2.The features of sex and age:The ratio of man VS woman in UC was 1.27:1, and most patients were between the ages of 30 to 39 and 50 to 59.And in CD group the ratio of man VS woman was 1.94:1,and most patients were 20 to 29 years old. 3.The distribution of occupation and habitation:The percentage of brainworker,physical labour,both brainworker and physical labour in UC group was 52.8%,37.2%and 10%respectively,whereas in CD group was 49%,45%and 9.4%correspondingly.The ratio of urban and rural area in UC group was 76.3%and 23.7%correspondingly,while in CD group was 70.6%and 29.4%respectively.4.The clinical manifestation:The symptom of UC group was diarrhea 79.7 %,abdominal pain 75.2%,bloody stool 76.5%,and rectal tenesmus 30.9 %,weight lose 34.3%and so on.The symptom in CD group was diarrhea 54.9 %,abdominal pain86.3%,bloody stool 41.2%,and feaver 31.4%,weight lose 54.9%,abdomen lump 17.6%.The arthropathy as the extraintestinal manifestations in UC group was 3.7%,and dermatonosis was 0.5%,dental ulcer was 0.3%,Veins thrombosis of lower extremity was 0.3%.Complication of UC group was 2.6%bowel obstruction,8.2%polypus,0.8%canceration,0.3% coreitis.The extraintestinal manifestations in CD group was 11.8% artbropathy,2.0%dermatonosis.Complication of CD group is 25.5%bowel obstruction,5.9%enterobrosis,5.9%fistula.5.The colonoscopy,pathology and radiology:The ratio of colonoscopy,pathology and radiology in 379 cases UC was 98.2%,56.2%,2.6%,respectively,The diagnose accordance rate of colonoscopy,pathology and radiology in UC group was 88.4%,24.4%,40%,respectively.And in CD group,the ratio of colonoscopy,pathology and radiology was 72.5%,78.4%,31.4%,respectively.The diagnose accordance rate of colonoscopy,pathology and radiology in CD group was 86.5%,27.5%,75%,respectively.6.The diease stage,state of an illness,clinical category and extent of disease:The diease stage of 100%in UC group was active,in which Mild, midst and heavy in the state of an illness was 38.3%,42.2%,19.5%, respectively.The initial type,chronic and relapse type,both chronic and persistent type,and acute outbreak type in the clinical category of UC group was 38.8%,46.7%,13.2%,1.3%,respectively.The extent of disease of UC group was 13.2%in rectum,26.9%in rectum-sigmoid colon,34.9%in left hemicolon,3.2%in right hemicolon,21.7%in whole colon.The relief stage and active phase in CD group was 7.8%,92.2%,respectively,in which Mild,midst and heavy in the state of an illness was 15.7%,43.1%, 41.2%,respectively.The type of stricture,perforation,inflammation in the clinical category of CD group was 25.5%,11.8%,62.7%,respectively. The extent of disease in CD group was 48.6%in ileocolon including ileocecal junction,21.6%in small bowel,29.7%in colon.7.The treament state:The management mode in UC group was 98.7%internal medicine treatment,and 1.3%operation.The mainstay for UC group medical treatment in the hospital was 78.1%5-aminosalicylate agents,and 53.3% glucocorticoids,2.6%immunodepressive.The effect of medical management in UC group was 97.3%all effective,2.4%ineffective,0.3%dead.The effect of operation in UC group was 100%whole effective,not ineffective and dead.The medical treatment of CD group was 66.7%,and operation was 33.3%.The main medical treatment was 62.7%5-aminosalicylate(5-ASA) agents,and 52.9%glucocorticoids,15.7%immunodepressive.The effect of medical treatment in CD group was 94.1%whole effctive,5.9% inefftive,respectively.The effect of operation in CD group was 82.4%whole effctive,5.9%inefftive,11.8%dead,respectively.Conclusions1.There has been an increasing number of hospitalized IBD in recent 10 years in Kunming.And in which UC was mainly increased.2.The sex of UC and CD group was man in the gender superiority.The mean age of onset in UC group was higher than CD.The age distribution in UC group was double hump.3.The distribution of occupation,habitation in IBD was intellectual work, and urban people.4.The major clinical manifestations of UC group were diarrhea,abdominal pain, bloody stools,and in CD group were abdominal pain,diarrhea,weight loss.The extraintestinal manifestations and complications of IBD were rare,which chief extraintestinal symptoms was arthropathy and complications was bowel obstruction.5.Colonoscopy combined with biopsy was the commonest diagnosis method in UC group,and the diagnose accordance rate was high.While in CD, colonoscopy,biopsy and radiology were main diagnosis methods,and the accordance rate of colonoscopy and radiology was also high.6.The main disease stage of UC and CD is active.The key state of an illness of UC group is mild and midist,and in CD group is midist and heavy.The main clinical type in UC group is initial type and chronicity relapse type,and CD is relapse-relief type.The major diseased region in UC group is recto-sigmoid colon and left hemicolon,and CD is ileocolon.7.(SASP)/5-ASA and steroids are stills the mainstay agents used for the treatment of mild and midis UC and midist and heavy CD,and the whole effective rate of medical and operation treatment in UC and CD were high.The ineffective rate and dead rate of UC and CD were low. |
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