背景:缺血性结肠炎(IC)也称为结肠缺血,是由结肠血管闭塞或非闭塞引起的,这导致结肠的血液供应减少,并且不足以维持细胞的代谢功能,导致肠壁缺血。其主要症状包括腹痛,腹泻,还有血淋淋的凳子.在严重的情况下,肠坏疽,腹膜炎,可能发生肠狭窄甚至肠梗阻。长期使用某些特殊药物引起的IC在临床实践中相对罕见。本文介绍了一例典型病例的临床诊断和治疗,为IC的治疗提供了新的治疗思路。
方法:患者入院时“腹痛半个月,便血伴粘液脓液3d”,诊断为“IC”。对症和支持治疗,如抗生素(左氧氟沙星),酸抑制和胃保护,补液,和静脉营养,给出了。患者的结肠溃疡被认为与口服血小板(PLT)升高胶囊有关;患者被要求停止血小板升高药物以通过结肠镜检查进行选择性检查,停用抗生素和美沙拉嗪肠溶片。在血液学会诊的指导下,给予60mg甲基强的松龙联合PLT输注以增加PLT。治疗后,患者病情稳定,病人的大便变黄了,病人的症状有所改善,病人被允许离开医院。
结论:PLT提高胶囊可导致IC,因此,临床医生应充分了解这些药物在治疗各种原因的血小板减少症中的应用,权衡利弊,并密切观察患者。
BACKGROUND: Ischemic colitis (IC) is also known as colon ischemia and is caused by colon vascular occlusion or nonocclusion, which results in a reduced blood supply to the colon and is not significant enough to maintain the metabolic function of cells, leading to intestinal wall ischemia. Its main symptoms include abdominal pain, diarrhea, and bloody stool. In severe cases, intestinal gangrene, peritonitis, intestinal stenosis and even intestinal obstruction may occur. IC induced by long-term use of certain special drugs is relatively rare in clinical practice. This article describes the clinical diagnosis and treatment of a typical case and provides a new treatment idea for the treatment of IC.
METHODS: The patient was admitted to the hospital with \"abdominal pain for half a month and bloody stool with mucous and pus for 3 d\" and was diagnosed with \"IC\". Symptomatic and supportive treatment, such as antibiotics (levofloxacin), acid inhibition and stomach protection, fluid replenishment, and intravenous nutrition, was given. The patient\'s colonic ulcers were considered to be related to the oral administration of platelet (PLT)-raising capsules; the patient was asked to stop PLT-raising drugs for selective review via colonoscopy, and antibiotics and mesalazine enteric-coated tablets were stopped. Under the guidance of hematology consultation, 60 mg of methylprednisolone was given in combination with PLT infusion to increase the PLT. After treatment, the patient\'s condition stabilized, the patient\'s stool turned yellow, the patient\'s symptoms improved, and the patient was allowed to leave the hospital.
CONCLUSIONS: PLT-raising capsules can lead to IC, so clinicians should have a full understanding of the application of these drugs in the treatment of various causes of thrombocytopenia, weigh the advantages and disadvantages, and observe patients closely.