Ikeuchi Hiroki, Yamamura Takehira, Nakano Hiroki, Kosaka Tadashi, Shimoyama Takashi, Fukuda Yoshihiro
Department of Surgery 2, Hyogo College of Medicine, Japan.
Hepatogastroenterology. 2004 Jul-Aug;51(58):1050-2.
BACKGROUND/AIMS: Enteral nutrition is the currently established primary therapy for Crohn's disease in Japan. We examined the effects of postoperative nutritional therapy in patients with perforating type and non-perforating type Crohn's disease.
We retrospectively reviewed the records for 218 patients who underwent surgical interventions for Crohn's disease in our hospital between January 1, 1974 and September 30, 2001. They were divided into four groups: 92 patients in the non-perforating type (NP type) + Elemental Diet (ED) group had received ED therapy and nutritional education, 22 patients in the NP type + NoED group had not received ED therapy or nutritional education, 88 patients in the perforating type (P type) + ED group and 16 patients in P type + NoED group. We evaluated the incidence of reoperation rate for each group.
Patients with a postoperative ED therapy demonstrated a significant decrease in the incidence of second resection. The incidence of second resection in the NP type + ED group was significantly lower than that of the other groups. The NP type + NoED group and the P type + ED group followed similar courses.
In patients with Crohn's disease postoperative ED therapy and nutritional education is effective in reducing the incidence of second resection. It appears that postoperative ED therapy and nutritional education is more important in patients with P type Crohn's disease.
背景/目的:在日本,肠内营养是目前已确立的克罗恩病主要治疗方法。我们研究了穿孔型和非穿孔型克罗恩病患者术后营养治疗的效果。
我们回顾性分析了1974年1月1日至2001年9月30日期间在我院接受克罗恩病手术治疗的218例患者的记录。他们被分为四组:92例非穿孔型(NP型)+要素饮食(ED)组患者接受了ED治疗和营养教育,22例NP型+无ED组患者未接受ED治疗或营养教育,88例穿孔型(P型)+ED组患者和16例P型+无ED组患者。我们评估了每组再次手术率的发生率。
接受术后ED治疗的患者二次切除率显著降低。NP型+ED组的二次切除率显著低于其他组。NP型+无ED组和P型+ED组的病程相似。
对于克罗恩病患者,术后ED治疗和营养教育可有效降低二次切除率。对于P型克罗恩病患者,术后ED治疗和营养教育似乎更为重要。