Zheng Xiao-Bin, Peng Xiang, Xie Xiao-Yu, Lian Lei, Wu Xian-Rui, Hu Jian-Cong, He Xiao-Wen, Ke Jia, Chen Yu-Feng, Zhi Min, Wu Xiao-Jian, He Xiao-Sheng, Lan Ping
The Sixth Affiliated Hospital, Sun Yat-sen University.
Department of Colorectal Surgery, The Sixth Affiliated Hospital of SYSU, China.
Rev Esp Enferm Dig. 2017 Dec;109(12):834-842. doi: 10.17235/reed.2017.5116/2017.
The impact of enteral nutrition (EN) on surgical risk in Crohn's disease (CD) patients suffering from spontaneous intra-abdominal abscess (IAA) was evaluated.
CD patients diagnosed with spontaneous IAA from 2008 to 2015 were included in the study. The impact of EN on surgical risk was evaluated using both univariate and multivariate analyses.
A total of 87 patients were enrolled, 66 (75.9%) were male. The mean age at the development of an abscess was 30.2 ± 10.1 years and the median duration of illness from CD diagnosis until the development of an abscess was three (2-6) years. After a median follow-up of 1.9 (1.1-2.9) years, surgical intervention was performed in 42 patients (48.3%). Patients treated with EN were less likely to require surgical intervention (26.1% vs 56.3%, p = 0.01). Multivariate analysis showed that EN was an independent protective factor for the risk of surgery with a hazard ratio of 0.27 (95% confidence interval: 0.11-0.65, p = 0.004) after adjusting for abdominal pain, history of abdominal surgery, concomitant intestinal stenosis and prior use of antibiotics within three months.
Surgical intervention is common for CD patients with IAA. Appropriate application of EN may help obviate the need for surgical treatment.
评估肠内营养（EN）对患有自发性腹腔内脓肿（IAA）的克罗恩病（CD）患者手术风险的影响。
纳入2008年至2015年诊断为自发性IAA的CD患者。使用单因素和多因素分析评估EN对手术风险的影响。
共纳入87例患者，66例（75.9%）为男性。脓肿发生时的平均年龄为30.2±10.1岁，从CD诊断到脓肿发生的疾病中位病程为3（2 - 6）年。中位随访1.9（1.1 - 2.9）年后，42例患者（48.3%）接受了手术干预。接受EN治疗的患者需要手术干预的可能性较小（26.1%对56.3%，p = 0.01）。多因素分析显示，在调整腹痛、腹部手术史、合并肠道狭窄和三个月内先前使用抗生素后，EN是手术风险的独立保护因素，风险比为0.27（95%置信区间：0.11 - 0.65，p = 0.004）。
IAA的CD患者手术干预很常见。适当应用EN可能有助于避免手术治疗的需要。
