溃疡性结肠炎的病情评估2013课件

溃疡性结肠炎的病情评估Evaluationandassessment

Beforestartingtreatment,patientsneedtobere-evaluatedforcorrectdiagnosis,andtoensurethatothercolitisandcoloniclesionshavebeenexcluded.Theanatomicallocationandextentofinflammation,severityanddiseaseactivity,presenceofextraintestinalmanifestationsandcomplicationsetc.shouldbescrutinizedtodecidethebestformoftreatment.Itisessentialtorememberthatacorrectdiagnosisisbasedonthecombinationofclinical,endoscopic,radiologicalandhistologicaldata.2ndEuropeanevidence-basedconsensusonthediagnosis/managementofulcerativecolitis2012ClinicalSubtype1、根据病程经过初发型慢性反复发作型慢性持续型急性爆发型(Acutefulminantcolitis)初发型慢性复发型2、根据病变部位和范围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直肠炎左半结肠炎广泛结肠炎3、根据病情轻度中度重度4、根据病情分期活动期缓解期《炎症性肠病诊断与治疗的共识意见》（2012年广州）MontrealclassificationAccordingtoDiseaseExtentSatsangiJ，SilverbergMS，VermeireS，eta1．TheMontrealclassificationofinflammatoryboweldisease：controversies，consensus，andimplications．Gut．2006，55：749—753．MontrealclassificationAccordingtoDiseaseSeverity

SatsangiJ，SilverbergMS，VermeireS，eta1．TheMontrealclassificationofinflammatoryboweldisease：controversies，consensus，andimplications．Gut．2006，55：749—753．SutherlandIndex（DAI）MayoScore

EndoscopicscoresStangeEF，TravisSP，VermeireS，etal，Europeanevidence-basedConsensusonthediagnosisandmanagementofulcerativecolitis：definitionsanddiagnosis．JCrohnsColitis，2008，2：1—23．Endoscopicscores(UCEIS)TravisSP,SchnellD,KrzeskiP,AbreuMT,AltmanDG,ColombelJF,etal.Developinganinstrumenttoassesstheendoscopicseverityofulcerativecolitis:theUlcerativeColitisEndoscopicIndexofSeverity(UCEIS).Gut2012;61:535–42.UCDAI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)：11