Gastroenterology Department, Hospital de São João. Porto, Portugal.
Curr Drug Targets. 2011 Sep;12(10):1454-61. doi: 10.2174/138945011796818144.
It is estimated that 50% of patients who have undergone ileal pouch-anal anastomosis (IPAA) surgery for UC will develop at least one episode of pouchitis. The risk of developing pouchitis is much higher in patients with preoperative extraintestinal manifestations and primary sclerosing cholangitis. In acute pouchtis metronidazole or ciprofloxacin have shown efficacy, however there is some evidence that ciprofloxacin may have better and has less toxic. In patients with chronic pouchitis antibiotics are less effective, and maintenance therapy may be required. In cases of refractoriness to conventional therapy a combination of two antibiotics for a prolonged period or infliximab may be effective. Starting maintenance treatment with highly concentrated probiotics is recommended as primary and secondary prophylaxis.
据估计，50%接受回肠储袋肛管吻合术（IPAA）治疗溃疡性结肠炎的患者至少会发生一次储袋炎。术前有肠道外表现和原发性硬化性胆管炎的患者发生储袋炎的风险更高。在急性储袋炎中，甲硝唑或环丙沙星已显示出疗效，但有一些证据表明环丙沙星可能效果更好且毒性更小。在慢性储袋炎患者中，抗生素的效果较差，可能需要维持治疗。对于常规治疗无效的病例，长时间联合使用两种抗生素或英夫利昔单抗可能有效。建议作为一级和二级预防，开始使用高浓度益生菌进行维持治疗。
