Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China (mainland).
Med Sci Monit. 2017 Oct 9;23:4841-4846. doi: 10.12659/msm.904238.
BACKGROUND Increasing evidence suggests that delayed diagnosis in Crohn's disease is associated with a complicated disease course. The aim of this study was to explore the association between delayed diagnosis and the timing of the first Crohn's disease-related intestinal surgery. MATERIAL AND METHODS A retrospective study included 215 Crohn's disease patients with previous surgical history in the Department of General Surgery of Jinling Hospital, China, between January 2013 and March 2016. Data were collected on demographics, clinical characteristics, medication history, and operation history. RESULTS The time from the first appearance of Crohn's disease-related symptoms to the first intestinal surgery in the delayed diagnosis group was obviously shorter than in the non-delayed diagnosis group (26.4±28.7 months vs. 42.6±58.4 months, respectively, p=0.032). Patients in the delayed diagnosis group tended to receive more ileal resections (47.8% vs. 26.4%, respectively, p=0.002) and less ileocecal resections (22.4% vs. 37.2%, respectively, p=0.032). More patients in the delayed diagnosis group received the first Crohn's disease-related intestinal surgery as an emergency one (20.9% vs. 4.7%, respectively, p=0.001). CONCLUSIONS Delayed diagnosis is associated with early and emergency need for the first Crohn's disease-related intestinal surgery.
越来越多的证据表明,克罗恩病的延迟诊断与复杂的疾病进程有关。本研究旨在探讨延迟诊断与克罗恩病相关的首次肠道手术时间之间的关系。
回顾性研究纳入了 2013 年 1 月至 2016 年 3 月在中国南京军区南京总医院普通外科接受过手术治疗的 215 例克罗恩病患者。收集了患者的人口统计学、临床特征、药物治疗史和手术史等数据。
延迟诊断组从出现克罗恩病相关症状到首次肠道手术的时间明显短于非延迟诊断组(分别为 26.4±28.7 个月和 42.6±58.4 个月,p=0.032)。延迟诊断组患者更倾向于接受回肠切除术(47.8% vs. 26.4%,p=0.002),而接受回盲部切除术的比例较低(22.4% vs. 37.2%,p=0.032)。更多的延迟诊断组患者需要紧急进行首次与克罗恩病相关的肠道手术(20.9% vs. 4.7%,p=0.001)。
延迟诊断与克罗恩病相关的首次肠道手术的早期和紧急需求有关。