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[慢性腹泻:临床方面]

[Chronic diarrhea: clinical aspects].

作者信息

Barreda F, Castillo T, Solari J, Román R

机构信息

Servicio de Gastroenterología, Hospital Nacional Edgardo Rebagllati Martins, IPSS, Lima-Perú.

出版信息

Rev Gastroenterol Peru. 1990;10(2):57-66.

PMID:2131003
Abstract

A retrospective study on the syndrome of chronic diarrhea was carried out on 50 revised clinical histories. The patients were hospitalized at the E. Rebaglati M. Hospital between April 1983 and March 1988. The purpose of the study was to evaluate the signs and symptoms of the syndrome, as well as the etiological agents and the methodology used for diagnoses. The selection criteria involved patients diagnosed as suffering from "chronic diarrhea of undetermined causes" upon entry. Seven were excluded due to incomplete study whereas 2 were diagnosed as acute infections diarrhea. Forty one patients were definite cases of chronic diarrhea and they were divided between 2 groups: the first one or Chronic Organic Diarrhea (58.53%) and the second one or Chronic Functional Diarrhea (41.46%). Out of the 41 revised clinical histories with chronic diarrhea, the following were the foundings: (1) the syndrome affects the economically active populations mainly and the length of the disease was more than 3 weeks in all the patients; (2) anemia, fever, weight loss, nightime bowel movements and bloody stools suggest organic problems whereas psychiatric disorders, daytime bowel movements, abdominal pain, disease recurrence and absence of detectable organic pathology suggest functional problems; (3) the most common cause of chronic diarrhea is the Irritable Bowel Syndrome followed by infectious diseases, with parasitosis in the first place; and (4) bearing in mind the mainly colonic affection and the predominant infectious diseases, the methodology used for their diagnosis would bring out good results.

摘要

对50份修订后的临床病历进行了一项关于慢性腹泻综合征的回顾性研究。患者于1983年4月至1988年3月期间在E. Rebaglati M.医院住院。该研究的目的是评估该综合征的体征和症状,以及病因和用于诊断的方法。选择标准包括入院时被诊断为“病因不明的慢性腹泻”的患者。7例因研究不完整被排除,2例被诊断为急性感染性腹泻。41例患者为慢性腹泻确诊病例,分为两组:第一组为慢性器质性腹泻(58.53%),第二组为慢性功能性腹泻(41.46%)。在41份修订后的慢性腹泻临床病历中,发现如下:(1)该综合征主要影响经济活跃人群,所有患者病程均超过3周;(2)贫血、发热、体重减轻、夜间排便和便血提示存在器质性问题,而精神障碍、白天排便、腹痛、疾病复发和未发现可检测到的器质性病变提示存在功能性问题;(3)慢性腹泻最常见的原因是肠易激综合征,其次是传染病,寄生虫病居首位;(4)考虑到主要为结肠受累和主要为传染病,用于其诊断的方法会取得良好效果。

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