Leifeld L, Kruis W
Abteilung für Innere Medizin, Evangelisches Krankenhaus Kalk, Köln, Deutschland.
Internist (Berl). 2008 Dec;49(12):1415-6, 1418-20. doi: 10.1007/s00108-008-2150-8.
New concepts are developed in the therapy of diverticular disease. 5-aminosalicylates can be administered in patients with slight forms of diverticulitis. In moderate diverticulitis antibiotics should be applied alternatively or additionally. In cases of severe diverticulitis patients should be kept fasting with parenteral nutrition and intravenous broad spectrum antibiotics. Small abscesses can be treated conservatively while abscesses larger than 4 cm should be drained in a first step and than treated surgically. A free perforation is still an absolute indication for emergency operation. In recurring diverticulitis indication for resection of the affected segment of the bowel should be considered depending on the extent of former attacks.
憩室病的治疗出现了新的理念。轻度憩室炎患者可使用5-氨基水杨酸酯。中度憩室炎患者应交替或额外使用抗生素。重度憩室炎患者应禁食并接受肠外营养及静脉注射广谱抗生素治疗。小脓肿可保守治疗，而直径大于4厘米的脓肿应首先进行引流，然后再进行手术治疗。游离穿孔仍然是急诊手术的绝对指征。对于复发性憩室炎，应根据既往发作的程度考虑是否切除受累肠段。
