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題名 | Managing Cytomegalovirus Colitis: Experience from 22 Patients at the Kaohsiung Veterans General Hospital=巨細胞病毒結腸炎:高雄榮總22例的經驗回顧 |
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作者姓名(中文) | 李元魁; 王瑞和; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 23:4 2012.12[民101.12] |
頁次 | 頁175-182 |
分類號 | 416.245 |
關鍵詞 | 巨細胞病毒結腸炎; 免疫組織化學法; Cytomegalovirus colitis; Immunohistochemistry; |
語文 | 英文(English) |
中文摘要 | 目的 巨細胞病毒結腸炎常發生在發炎性腸疾或免疫力不全的病患上,但其臨床表徵、內視鏡病變和預後有很大差異性,這篇文章針對本院對巨細胞病毒結腸炎的治療經驗提供分享。方法 本研究收集自2001至2011年間,在本院有紀錄之巨細胞病毒結腸炎的22例病患,分析其臨床表徵、合併疾病,內視鏡病變、治療及預後。結果 大部分病患大於60歲,最常見的合併疾病包括心血管疾病、肺疾和敗血症,最常見的臨床症狀為腹瀉、發燒、腹痛和便血,所有病患皆用免疫組織化學法診斷,最常見的內視鏡病變為合併潰瘍的結腸炎或單獨性結腸炎,有18名病患接受抗病毒藥物治療,其中12名病患治療後症狀緩解,三名接受手術治療的病患最終死亡。結論 巨細胞病毒結腸炎的症狀變化很大,完整的大腸鏡檢查和組織切片合併免疫組織化學染色可診斷大部分的病例,抗病毒療法是主要的治療方式,病患的預後與他們合併的疾病相關,高度警覺和早期診斷可使此類病患有較好的預後。 |
英文摘要 | Purpose. Cytomegalovirus (CMV) colitis usually occurs in patients with inflammatory bowel disease (IBD) or those who are immunocompromised. However, clinical manifestations, endoscopic appearance and the clinical course vary. This report presents our experience with diagnosis and treatment of CMV colitis at the Kaohsiung Veterans General Hospital.Methods. Twenty-two patients, from 2001 to 2011, with CMV colitis were retrospectively analyzed. Their underlying comorbidities, endoscopic findings, treatment and outcomes were assessed.Results. Most patients were older than 60 years old. Common comorbidities included cardiovascular disease, pulmonary disease and sepsis. Most patients presented with diarrhea; others presented with fever, abdominal pain and hematochezia. All patients were diagnosed with immunohistochemistry (IHC). Colitis with or without ulcer was the most common endoscopic appearance. Eighteen patients received antiviral therapy and 12 of them had symptomatic relief. Three patients who underwent surgery eventually expired.Conclusion. CMV colitis can present with variable clinical manifestations. Full-length colonoscopy and tissue biopsy confirmation with immunohistochemical stain is required to diagnose CMV colitis in most cases. Antiviral therapy is still the mainstay of treatment. The prognosis of such patients is closely related to their underlying comorbidities. Early recognition and a high degree of suspicion of this clinical entity is needed to ensure a better prognosis of the patients. |
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