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阑尾切除术在炎症性肠病后续发展中的作用:一项基于英国的研究。

The role of appendicectomy in the subsequent development of inflammatory bowel disease: a UK-based study.

机构信息

Hereford County Hospital, Hereford, UK.

出版信息

Int J Colorectal Dis. 2010 Apr;25(4):509-13. doi: 10.1007/s00384-009-0865-1. Epub 2009 Dec 15.

Abstract

BACKGROUND

Several studies have shown an inverse relationship between appendicectomy and subsequent development of inflammatory bowel disease (IBD), although these findings remain contentious. This study aims to further elucidate the role appendicitis/appendicectomy has in the development of IBD.

METHOD

All patients undergoing appendicectomy at Hereford County Hospital between 1986 and 2005 were identified from pathology records. Those already diagnosed with IBD were excluded. Age- and sex-matched controls were randomly selected from a database of orthopaedic clinic attendees. Those with prior history of IBD or appendicectomy were excluded. The incidence of IBD was determined by cross-referencing with the histology database, colonoscopy database and IBD register.

RESULTS

Three thousand eight hundred twenty-nine patients were included in each group, with mean follow-up of 12 +/- 5.9 years. Twelve patients in the appendicectomy group developed IBD. Mean age at diagnosis was 30.3 years, and mean interval from appendicectomy of 3.7 years. Age at appendicectomy and appendicectomy for appendicitis conferred no benefit (Mann-Whitney test, p = 0.991). Eleven patients in the control group developed IBD, with no significant differences in any of the measured outcomes.

CONCLUSION

This study has shown no relationship between appendicitis/appendicectomy and development of IBD.

摘要

背景

多项研究表明阑尾切除术与炎症性肠病(IBD)的后续发展之间存在反比关系,尽管这些发现仍存在争议。本研究旨在进一步阐明阑尾炎/阑尾切除术在 IBD 发展中的作用。

方法

从病理记录中确定了 1986 年至 2005 年期间在赫里福德郡医院接受阑尾切除术的所有患者。排除已经诊断为 IBD 的患者。从骨科诊所就诊者的数据库中随机选择年龄和性别匹配的对照组。排除有 IBD 或阑尾切除术既往史的患者。通过与组织学数据库、结肠镜检查数据库和 IBD 登记处交叉引用来确定 IBD 的发病率。

结果

每组纳入 3829 例患者,平均随访 12 +/- 5.9 年。阑尾切除术组中有 12 例患者发生 IBD。诊断时的平均年龄为 30.3 岁,阑尾切除术的平均间隔为 3.7 年。阑尾切除术的年龄和因阑尾炎而行阑尾切除术并没有带来益处(Mann-Whitney 检验,p = 0.991)。对照组中有 11 例患者发生 IBD,在所有测量结果中均无显著差异。

结论

本研究表明阑尾炎/阑尾切除术与 IBD 的发展之间没有关系。

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