溃疡性结肠炎的病情评估.ppt

溃疡性结肠炎的病情评估.ppt

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溃疡性结肠炎的病情评估溃疡性结肠炎的病情评估EvaluationandassessmentEvaluationandassessmentnBeforestartingtreatment,patientsneedtobere-evaluatedforcorrectdiagnosis,andtoensurethatothercolitisandcoloniclesionshavebeenexcluded.Theanatomicallocationandextentofinflammation,severityanddiseaseactivity,presenceofextraintestinalmanifestationsandcomplicationsetc.shouldbescrutinizedtodecidethebestformoftreatment.nItisessentialtorememberthatacorrectdiagnosisisbasedonthecombinationofclinical,endoscopic,radiologicalandhistologicaldata.n2ndEuropeanevidence-basedconsensusonthediagnosis/managementofulcerativecolitis2012ClinicalSubtypen1、根据病程经过n初发型慢性反复发作型慢性持续型急性爆发型（Acutefulminantcolitis）n初发型慢性复发型n2、根据病变部位和范围n直肠炎和直乙结肠炎左半结肠炎右半结肠炎区域性结肠炎全结肠炎n直肠炎左半结肠炎广泛结肠炎n3、根据病情n轻度中度重度n4、根据病情分期n活动期缓解期炎症性肠病诊断与治疗的共识意见（2012年广州）TrueloveandWittsSeverityIndexTrueloveSC,WittsLJ.Cortisoneinulcerativecolitis.Finalreportonatherapeutictrial.BMJ1955;2:

10411048.MontrealclassificationAccordingtoDiseaseExtentSatsangiJ，SilverbergMS，VermeireS，eta1TheMontrealclassificationofinflammatoryboweldisease：

controversies，consensus，andimplicationsGut2006，55：

749753MontrealclassificationAccordingtoDiseaseSeveritySatsangiJ，SilverbergMS，VermeireS，eta1TheMontrealclassificationofinflammatoryboweldisease：

controversies，consensus，andimplicationsGut2006，55：

749753SutherlandIndexSutherlandIndex（DAIDAI）MayoScorenSutherlandIndexSutherlandIndex（alsocalledMayoscores）（alsocalledMayoscores）nSchroederKW,TremaineWJ,IlstrupDM.Coatedoral5-aminosalicylicacidtherapyformildlytomoderatelyactiveulcerativecolitis,arandomizedstudy.NEnglJMed1987;317:

16259.nSutherlandLR,MartinF,GreerS,etal.5-Aminosalicylicacidenemainthetreatmentofdistalulcerativecolitis,proctosigmoiditis,andproctitis.Gastroenterology1987;92:

18948.EndoscopicscoresEndoscopicscoresStangeEF，TravisSP，VermeireS，etal，Europeanevidence-basedConsensusonthediagnosisandmanagementofulcerativecolitis：

definitionsanddiagnosisJCrohnsColitis，2008，2：

123BaronBaroneendoscopicscoresndoscopicscoresBaronJHConnellAMLennard-JonesJEVariationbetweenobserversindescribingmucosalappearancesinproctocolitisBrMedJ.1964。

1：

8992EndoscopicscoresEndoscopicscores（UCEIS）（UCEIS）TravisSP,SchnellD,KrzeskiP,AbreuMT,AltmanDG,ColombelJF,etal.Developinganinstrumenttoassesstheendoscopicseverityofulcerativecolitis:

theUlcerativeColitisEndoscopicIndexofSeverity（UCEIS）.Gut2012;61:

53542.HistologicfindingsnTrueloveSC,RichardsWC.Biopsyresultsinulcerativecolitis.BrMedJ.1956;1:

13151318.nRileySA,ManiV,GoodmanMJ,etal.Microscopicactivityinulcerativecolitis:

whatdoesitmean?

Gut.1991;32:

174178.nGeboesK,RiddellR,OstA,etal.AreproduciblegradingscaleforhistologicalassessmentofinflammationinUC.Gut.2000;47:

404409.nBittonA,PeppercornMA,AntonioliDA,etal.Clinical,biological,andhistologicparametersaspredictorsofrelapseinulcerativecolitis.Gastroenterology.2001;120:

1320.nThiaKT,LoftusEVj,PardiDS,etal.Measurementofdiseaseactivityinulcerativecolitis:

Interobserveragreementandpredictorsofseverity.InflammBowelDis2010.UCDAIUCDAI钱家鸣，等.溃疡性结肠炎的临床表现和分型.现代消化及介入诊疗.2008，13

（2）：

111-114.DifferentgradesusedforevaluationofdiseaseseverityinUChistologically感谢您的观看！