Department of General and Colorectal Surgery, Victoria Hospital, Kirkcaldy, Fife, UK.
Colorectal Dis. 2012 Nov;14(11):e751-63. doi: 10.1111/j.1463-1318.2012.03171.x.
The study reviews the literature related to ischaemic colitis (IC) to establish an evidence base for its management and to identify factors predicting severity and mortality.
A systematic review of the English language literature was conducted according to recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. MEDLINE, Embase and Cochrane Library databases were searched using the keyword search 'ischaemic colitis OR colon ischaemia OR colonic ischaemia OR management ischaemic colitis'. IC is often misdiagnosed so only studies where the diagnosis was supported by histopathology in every case were included. Critical appraisal was performed of included studies using predefined quality assessment checklists and narrative data synthesis.
In all, 2610 publications were identified. Of these, eight retrospective case series and three case controlled studies describing 1049 patients were included. Medical management was used in 80.3% patients of whom 6.2% died. Surgery was required in 19.6% of whom 39.3% died. The overall mortality of IC was 12.7%. Lack of rectal bleeding, peritonism and renal dysfunction were commonly quoted predictors of severity; however, right sided IC appeared to be the most significant predictor of outcome.
Most patients with IC can be managed conservatively. Right sided IC may be the most significant predictor of severity.
本研究回顾了与缺血性结肠炎（IC）相关的文献，旨在为其治疗建立循证医学基础，并确定预测严重程度和死亡率的相关因素。
根据系统评价和荟萃分析首选报告项目（PRISMA）的建议，对英文文献进行了系统回顾。使用关键词搜索“ischemic colitis OR colon ischemia OR colonic ischemia OR management ischemic colitis”，检索了 MEDLINE、Embase 和 Cochrane Library 数据库。仅纳入了每项病例均通过组织病理学支持诊断的研究，因为 IC 常被误诊。使用预先定义的质量评估清单和叙述性数据综合对纳入的研究进行了批判性评估。
共确定了 2610 篇出版物。其中，有 8 项回顾性病例系列研究和 3 项病例对照研究描述了 1049 例患者。80.3%的患者接受了药物治疗，其中 6.2%的患者死亡。19.6%的患者需要手术治疗，其中 39.3%的患者死亡。IC 的总体死亡率为 12.7%。缺乏直肠出血、腹膜炎和肾功能不全是常被引用的严重程度预测因素；然而，右侧 IC 似乎是最显著的预后预测因素。
大多数 IC 患者可以通过保守治疗进行管理。右侧 IC 可能是严重程度的最显著预测因素。
