Steinberg D M, Allan R N, Brooke B N, Cooke W T, Williams J A
Gastroenterology. 1975 Jan;68(1):33-9.
A comparison is made of the immediate and long term mortality of colectomy and ileostomy between 73 patients who had Crohn's colitis and 442 who had ulcerative colitis. The immediate mortality in Crohn's disease is 4%. In ulcerative colitis it is 10%, chiefly because of the higher proportion of emergency operations. The late mortality in both groups is 10%, chiefly as a result of recurrence of Crohn's disease or the sequellae of colonic malignancy present at the time of colectomy for ulcerative colitis. A further comparison is made between the postoperative course of the 64 surviving patients with Crohn's disease and a comparable sample of 65 patients who had an ileostomy for ulcerative colitis in the same era. There was a similar incidence of postoperative septic complications in the two groups (35%). The readmission rate was twice as high in the Crohn's disease patients. Ileostomy reconstruction for mechanical complication was needed in 21 patients with Crohn's disease compared with 6 with ulcerative colitis. Further ileal resection was required for recurrent disease on another 25 occasions in the patients with Crohn's disease but never in those with ulcerative colitis. Long therm review graded the clinical status as excellent or good in 70% of those with Crohn's disease compared with 95% with ulcerative colitis.
对73例患有克罗恩病性结肠炎的患者和442例患有溃疡性结肠炎的患者进行结肠切除术和回肠造口术的近期和长期死亡率比较。克罗恩病的近期死亡率为4%。溃疡性结肠炎的近期死亡率为10%，主要是因为急诊手术的比例较高。两组的远期死亡率均为10%，主要是由于克罗恩病复发或在溃疡性结肠炎行结肠切除术时存在的结肠恶性肿瘤后遗症。对64例存活的克罗恩病患者的术后病程与同期65例因溃疡性结肠炎行回肠造口术的类似样本进行了进一步比较。两组术后感染并发症的发生率相似（35%）。克罗恩病患者的再入院率是溃疡性结肠炎患者的两倍。21例克罗恩病患者因机械性并发症需要进行回肠造口重建，而溃疡性结肠炎患者有6例。克罗恩病患者因疾病复发还需要另外25次进行回肠切除术，而溃疡性结肠炎患者则从未需要。长期随访将70%的克罗恩病患者的临床状况评为优秀或良好，而溃疡性结肠炎患者为95%。
