Cho Su Min, Cho Sung W, Regueiro Miguel
Department of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Med Clin North Am. 2010 Jan;94(1):179-88. doi: 10.1016/j.mcna.2009.08.019.
Crohn disease often recurs after surgical resection. Despite extensive research in the prevention of postoperative Crohn disease, optimal management strategies have yet to be defined. Risk of disease recurrence needs to be carefully balanced against potential risks associated with treatment. Patients with low risk of postoperative recurrence may not require medication, whereas those at moderate risk may benefit from antibiotics or immunomodulators. Those at highest risk of recurrence may benefit from biologic therapy for maintenance of surgical remission. Postoperative colonoscopy within 1 year of resective surgery is important for identification of disease recurrence and modification of medications.
克罗恩病在手术切除后常复发。尽管在预防术后克罗恩病方面进行了广泛研究,但最佳管理策略尚未明确。疾病复发风险需要与治疗相关的潜在风险仔细权衡。术后复发风险低的患者可能不需要药物治疗,而中度风险患者可能从抗生素或免疫调节剂中获益。复发风险最高的患者可能从生物治疗中获益以维持手术缓解状态。在切除手术后1年内进行术后结肠镜检查对于识别疾病复发和调整药物治疗很重要。