Department of Biosurgery and Surgical Technology, Imperial College London, Loondon, UK.
Aliment Pharmacol Ther. 2009 Jan;29(1):69-74. doi: 10.1111/j.1365-2036.2008.03858.x. Epub 2008 Oct 3.
Pre-pouch ileitis is a recently described condition which may occur following restorative proctocolectomy. Its aetiology remains unknown and only one study has reported the effect of treatment. We report a series of fourteen patients treated and followed up with repeat pouchoscopy.
To study the effectiveness of antibiotics for the treatment of pre-pouch ileitis following restorative proctocolectomy with ileal pouch-anal anastomosis.
Fourteen consecutive patients with symptomatic pre-pouch ileitis were treated with ciprofloxacin 500 mg b.d. and metronidazole 400 mg b.d. for 28 days. All had concurrent pouchitis. Symptomatic, endoscopic and histological assessment was performed before and following treatment using the pouchitis disease activity index (PDAI). Symptomatic remission was defined as a score of 0 in the clinical component of the PDAI.
Twelve (86%) patients experienced symptomatic remission. Stool frequency fell from a median of 12 (range 8-20) to 6 (4-17) (P = 0.002). There was a significant reduction in the anatomical length of pre-pouch ileitis with nine (64%) patients having either a resolution or a reduction in length of pre-pouch ileitis from a median of 10 cm (range 3-20 cm) to a median of 1 cm (range 0-10 cm) (P = 0.007).
Combination antibiotic therapy in this uncontrolled study appears effective in reducing the length of pre-pouch ileitis and in inducing symptomatic remission in most patients whether or not its extent is reduced.
术前回肠炎是一种新描述的疾病，可能发生在直肠结肠切除术后。其病因尚不清楚，只有一项研究报道了治疗效果。我们报告了一组 14 例接受治疗并重复进行回肠袋内镜检查的患者。
研究抗生素治疗直肠结肠切除术后回肠袋-肛门吻合术的术前回肠炎的疗效。
14 例有症状的术前回肠炎患者接受环丙沙星 500mg，bid 和甲硝唑 400mg，bid 治疗 28 天。所有患者均同时患有袋炎。在治疗前后使用回肠炎疾病活动指数（PDAI）进行症状、内镜和组织学评估。症状缓解定义为 PDAI 临床成分评分为 0。
12 例（86%）患者出现症状缓解。粪便频率从中位数 12（范围 8-20）降至 6（范围 4-17）（P = 0.002）。术前回肠炎的解剖长度明显缩短，9 例（64%）患者的术前回肠炎长度要么完全缓解，要么从中位数 10cm（范围 3-20cm）缩短至中位数 1cm（范围 0-10cm）（P = 0.007）。
在这项非对照研究中，联合抗生素治疗似乎有效，可减少术前回肠炎的长度，并在大多数患者中诱导症状缓解，无论其范围是否缩小。
