Clinical Analysis Of Ischemic Bowel Disease Of 140 Cases

Objective:The clinical characteristics of ischemic bowel disease was analysed in this paper to find the independent risk factors and the major misdiagnosis reasons of this disease.Better methods with high sensitivity in diagnosing the disease was explored in this paper through comparing several imaging examination methods ` detection rate of this disease.The indicators which reflect the prognosis of the disease was found in this paper through analyzing the relationship between the assay indexes and prognosis.Methods:In January 5th of 2006 to June 28 th of 2016,the clinical data of 140 patients with the diagnosed ischemic bowel disease in The Second Hospital of Dalian Medical University were analysed retrospectively with chi-square tests,multivariate unconditional Logistic regression analysis,Mann-Whitney U test and ROC curve.Results:1.General conditions: there are totally 140 samples of patients,including 63 male patients(45%)and 77 female patients(55%),with a ratio of 9:11.most patients are among 50 to 85 years old.2.Clinical features: All the patients of this group are suffered from bellyache except nine(6.4%).51 out of 140 patients had bellyache but without abdominal signs(36.4%,51/140)while 80 patients concomitently had bellyache and abdominal signs(57.1%,80/140).66 out of 140 patients were detected with blood in their stools.3.Laboratory tests: 84 patients received examinations of D-dimer,among which53 patients were with an increase in D-dimer,accounting for 63.1%(53/84).55 patients received examinations of lactic acid and 35 of them were found with an increased level of lactic acid,accounting for 63.6%(35/55).4.The judgment of the white blood cell,lactic dehydrogenase,lactic acid,D-dimer,and HCT on the prognosis of the ischemic bowel disease:When the white blo-od cells were no less than 10.75×109/L,lactic dehydrogenase was no less than 259.5IU/L,lactic acid was no less than 2.25mmol/L,and D-dimer was no less than 2.33?g/ml,the prognosis of the ischemic bowel disease is poor,meanwhile with a high mortality.Otherwise,the result would be reversed.There were no differences between survival group and death group about HCT(P>0.05).5.Imageological examination:(1)There were 59 patients in this group having received abdominal color doppler ultrasound.The examination results have shown that 2 patients were suffering from mesenteric venous thrombosis.1 patient was discovered with superior mesenteric artery thrombosis and the other 1 was suffering superior mesenteric artery embolus.(2)22 patients have received enhancement CT.2 patients were found with superior mesenteric artery embolus and 1 patient was suffering from mesenteric venous thrombosis.(3)56 patients have received mesenteric vessel CTA,among which 36 patients were suffering from mesenteric vessel embolization,stenosis or thrombosis.(4)12 patients received DSA,11 of which were positive and another 1 was negative.(5)86 patients received colonoscopy and 82 of them were suffering from ischemic bowel diseases.(6)There were no significant differences between the positive detectable rates of DSA and CTA(P>0.05).The positive detectable rates of the colonoscope was higher than that of CTA(P<0.05).6.Misdiagnosis(1)50 out of 140 patients were misdiagnosed(35.7%),mostly misdiagnosed as intestinal obstruction.(2)The comparison between misdiagnosed patients and those who were not: we compared the misdiagnosed patients and those who were not,when they were discovered with blood in stool,flatus and defecation were stopped,and emesis,p was less than 0.05,with statistical significance.7.Analysis on dangerous factors: Age no less than 60,hypertension,smoking,atrial fibrillation,diabetes,abdominal operation,coronary heart disease,live cirrhosis,hyperlipidemia,SLE,cerebral embolism and atherosclerosis are the risk factor of the ischemic bowel disease.People who are 60 years old and above,atherosclerosis,and hyperlip-idemia are independent risk factors of the ischemic bowel disease.8.Treatment:The treatment methods include medical conservative treatment,surgery treatment and interventional therapy.9.There are totally 30 patients died in this group,with a death rate of21.4%(30/140).Conclusions: Patients who are 60 years old and above,atherosclerosis,and hyperlipidemia are most prone to develop ischemic bowel disease.WBC,LDH,lactic acid and D-dimer are increased indicated poor prognosis.