| Objective:Through retrospective analysis of the clinical materials of 93 patients with ischemic bowel disease and further exploring the risk factors of clinical characteristics,morbidity and risk factors of prognosis mala,clinicians can have a better understanding of this disease and early detection and treatment of this disease can be ensured,thus improving the prognosis.Materials and Methods:Retrospectively analysis is carried out to the clinical materials of 93 patients who were hospitalized in the Department of Gastroenterology,First Affiliated Hospital of Fujian Medical University with ischemic bowel disease from October 1,2015 to September 30,2018;a comparison is conducted to the clinical materials of the group of ischemic bowel disease（n=93）and the group of functional gastrointestinal disease（n=165）in the same period,the method of single factor combined with multiple factors is adopted to analyze the general materials and basic diseases of the two groups in order to find out the risk factors of ischemic bowel disease,and an exploration is carried out to the diagnostic value of D-dimer,fibrinogen and the ratio of them for the disease;According to the treatment effect and outcome of ischemic bowel disease,the patients were divided into the good prognosis group（n=85）and the poor prognosis group（n=8）.The single factor method is adopted to explore the correlation of general materials,personal history,basic diseases,abdominal surgery history,antibiotic use and prognosis and result and analyze the potential factors related to prognosis.Results:1.The ratio of male to female is 1:1.07 in 93 patients with ischemic bowel disease,with an average age of（65.85±13.53）years,of which the elderly take up 66.67%.In personal history,smoking and drinking accounted for the highest proportion,respectively for smoking（24 cases,25.81%）and drinking（15 cases,16.13%）.The basic diseases are common in arteriosclerosis（72 cases,77.84%）and hypertension（52 cases,55.91%）.2.The incidence of ischemic bowel disease is more common in chronic mesenteric ischemia,followed by ischemic colitis,and the lowest in acute mesenteric ischemia.The cardinal symptoms of the main clinical manifestations are abdominal pain（87cases,93.55%）and hematochezia（45 cases,48.39%）.The most common symptoms are mid-lower abdominal pain（25 cases,26.88%）and periumbilical pain（19 cases,20.43%）and other symptoms are diarrhea,nausea,vomiting,fever,abdominal distention,dizziness and amaurosis.Most of the signs are local slight tenderness,and15 cases（16.13%）have peritoneal irritation signs.3.The increase of D-dimer and positive OB happens in 63.44%and 69.89%of the patients with ischemic bowel disease.The mainstream examination methods of ischemic bowel disease are CT angiography and colonoscopy and their positive rates are 87.18%and 32.35%respectively.4.93 patients receive medical therapy,4 patients are given surgical services after failure in the medical therapy and 1 patient receives interventional therapy.91.40%of them got the effective medical therapy,but 8 cases were still ineffective,of which one died.5.In the single-factor and multiple-factor analysis of the risk factors of ischemic bowel disease,the results show that its independent risk factors are coronary disease（P=0.026）,atherosclerosis（P=0.000）,D-dimer（P=0.000）and fibrinogen（P=0.021）.In the single-factor analysis of the risk factors for the prognosis mala of ischemic bowel disease,it is suggested that the predictive factors of prognosis mala can be the decrease of albumin,hemoglobin and red cells and the increase of C-reactive protein.6.The D-dimer,fibrinogen and their ratio（P=0.000）have certain diagnostic values for ischemic bowel disease.The optimal cut-off values for the diagnosis of ischemic bowel disease are 0.2950 mg/L,2.715 g/L and 1.163×10-4 respectively.Conclusion:Ischemic bowel disease usually happens in the elderly with coronary disease and atherosclerosis.Its clinical manifestations are atypical,with the major symptoms of abdominal pain and hematochezia.The symptoms are severe while the signs are mild without any specific laboratory examination index.The increase of D-dimer and positive OB have a certain reference value,CT angiography and colonoscopy are of great value in diagnosis,the increase of the original ratio of D-dimer to fibrinogen can support the diagnosis and the predictive factors of prognosis mala can be the decrease of albumin,hemoglobin and red cells and the increase of C-reactive protein. |
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