炎症性肠病的并发症太原市兴安医院（０３０００８）王丽华某些ＩＢＤ病人以并发症而首先就诊，因此认识和掌握并发症有助于对本病的诊断和治疗。一、肠道并发症克隆氏病常并发：①肠梗阻，占２０～３０％，可发生于肠道任何部位，以末端回肠为多见，由管壁纤维化和管腔狭窄引起。②瘘管形成，可有肠内外瘘，约半数发生在肛门周围和回盲部，若瘘管口形成脓肿，则出现全身感染的表现。③肛门周围病变，有持续性肛裂、肛瘘、溃疡和脓肿，多见于结肠克隆氏病。④肠出血，仅有小肠局限性病变者多为隐血；结肠病变成广泛小肠病变时则以血便为主。大出血少见，直肠受累者４０％发生出血。⑤肠穿孔，罕见。⑥癌变与中毒性巨结肠，少见。溃疡性结肠炎肠道并发症约为２３％，①急性结肠扩张与溃疡穿孔，急性暴发型的结肠病变累及肌层时，可致肠壁平滑肌张力减低而引起结肠扩张，受累结肠大量充气使腹部膨隆，肠鸣音减弱或消失。在结肠扩张基础上易引起结肠溃疡穿孔并发急性弥漫性腹膜炎，②结肠和肛周疾病，有肛裂、肛瘘、直肠脱垂、肛周脓肿等。③结肠假息肉形成，少数可发生癌变。④结肠大量出血，多发生于急性暴发型溃疡结肠炎。⑤肠梗阻，修复过程中大量纤维组织形成可引起结肠狭窄。进而发展成肠梗阻。二、 Complications of inflammatory bowel disease Xingan Hospital, Taiyuan (030008) Wang Lihua Some IBD patients first visit with complications, so understanding and mastery of complications help to the diagnosis and treatment of the disease. First, intestinal complications Crohn’s disease often complicated: ① intestinal obstruction, accounting for 20 to 30%, can occur in any part of the intestine to terminal ileum is more common, caused by the wall fibrosis and stenosis. ② fistula formation, there may be intestinal fistula, about half occurred around the anus and ileocecal Department, if the formation of abscess fistula mouth, then the performance of systemic infection. ③ lesions around the anus, there is persistent anal fissure, anal fistula, ulcers and abscesses, more common in colon Crohn’s disease. ④ intestinal bleeding, only the limitations of small bowel lesions are mostly occult blood; colon disease into a wide range of small bowel lesions blood to the main. Bleeding rare, rectal bleeding affected by 40%. ⑤ intestinal perforation, rare. ⑥ cancer and toxic megacolon, rare. Intestinal complications of ulcerative colitis is about 23%, ① acute colon dilatation and ulcer perforation, acute fulminant colon lesions involving the muscular layer, can cause decreased tension in the smooth muscle of the intestine wall caused by the expansion of the colon, a large number of inflamed colon so that the abdomen Bulging, bowel sounds weakened or disappeared. Based on the expansion of the colon can cause colon ulcer perforation complicated by acute diffuse peritonitis, ② colon and perianal disease, anal fissure, anal fistula, rectal prolapse, perianal abscess and so on. ③ colon false polyps formation, a few may occur cancer. ④ a large number of colon bleeding, occurred in acute fulminant ulcer colitis. ⑤ intestinal obstruction, a large number of fibrous tissue repair process can cause colon stenosis. And then developed into intestinal obstruction. two,