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[克罗恩病小肠定位的外科治疗]

[Surgical management of small bowel localization of Crohn's disease].

作者信息

Pătraşcu Tr, Catrina E, Doran H, Mihalache O, Bugă C, Degeratu D, Predescu G

机构信息

Clinica de chirurgie Prof. I. Juvara, Spitalul Clinic Dr. I. Cantacuzino, Bucureşti.

出版信息

Chirurgia (Bucur). 2009 Nov-Dec;104(6):705-14.

Abstract

Crohn's disease is an inflammatory bowel disease, a chronic condition with recurrent relapses, difficult to diagnose and requiring a complex medical and surgical treatment. Analyzing 11 patients admitted in the surgical Clinique between 2003 and 2008 with Crohn's disease diagnostic, the authors study at the 7 patients operated the reason of the surgical interventions represented by the complications of the inflammatory disease--intestinal obstruction 2 cases, peritonitic syndrome in 3 cases, malignization 1 case, enterovesical fistulae--1 case. Intraoperatory the differential diagnosis between an inflammatory or tumoral etiology of the lesions was very difficult, and the surgical indication was in almost all cases for enteral resection. Postoperative evolution was in most cases with complications (5 cases)--unique anastomotic fistulae 2 cases, or recurrent fistulae in 3 cases, late bowel obstruction--2 cases. Studying the literature, it can be concluded that the surgical treatment is only one stage of the complex treatment that must be individualized for each case and applied only to the complications of the disease.

摘要

克罗恩病是一种炎症性肠病,是一种具有复发倾向的慢性疾病,难以诊断,需要复杂的药物和手术治疗。通过分析2003年至2008年期间在外科诊所收治的11例诊断为克罗恩病的患者,作者对7例接受手术的患者进行了研究,这些手术干预的原因是炎症性疾病的并发症——肠梗阻2例、腹膜炎综合征3例、恶性病变1例、肠膀胱瘘1例。术中,病变的炎症性或肿瘤性病因的鉴别诊断非常困难,几乎所有病例的手术指征都是肠切除。术后大多数病例出现并发症(5例)——单纯吻合口瘘2例,或复发性瘘3例,晚期肠梗阻2例。通过研究文献可以得出结论,手术治疗只是综合治疗的一个阶段,必须针对每个病例进行个体化治疗,并且仅适用于该疾病的并发症。

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