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本文引用的文献

1
Economic implications of biological therapy for Crohn's disease.克罗恩病生物治疗的经济影响
Prz Gastroenterol. 2015;10(4):197-202. doi: 10.5114/pg.2015.55749. Epub 2015 Nov 23.
2
Risk factors for postoperative intra-abdominal septic complications after surgery in Crohn's disease: A meta-analysis of observational studies.克罗恩病术后腹腔内感染性并发症的危险因素:观察性研究的荟萃分析。
J Crohns Colitis. 2015 Mar;9(3):293-301. doi: 10.1093/ecco-jcc/jju028. Epub 2015 Jan 8.
3
Impact of perioperative immunosuppressive medication on surgical outcome in Crohn's Disease (CD).围手术期免疫抑制药物对克罗恩病(CD)手术结局的影响。
Z Gastroenterol. 2014 May;52(5):436-40. doi: 10.1055/s-0033-1356347. Epub 2014 May 13.
4
Anti-tumor necrosis factor therapy is associated with infections after abdominal surgery in Crohn's disease patients.抗肿瘤坏死因子治疗与克罗恩病患者腹部手术后感染有关。
Am J Gastroenterol. 2013 Apr;108(4):583-93. doi: 10.1038/ajg.2012.464. Epub 2013 Mar 12.
5
The risks of post-operative complications following pre-operative infliximab therapy for Crohn's disease in patients undergoing abdominal surgery: a systematic review and meta-analysis.术前英夫利昔单抗治疗克罗恩病患者行腹部手术后术后并发症的风险:系统评价和荟萃分析。
J Crohns Colitis. 2013 Dec;7(11):868-77. doi: 10.1016/j.crohns.2013.01.019. Epub 2013 Mar 5.
6
Pre-operative use of anti-TNF-α agents and the risk of post-operative complications in patients with Crohn's disease--a nationwide cohort study.术前使用抗 TNF-α 药物与克罗恩病患者术后并发症风险的关系——一项全国性队列研究。
Aliment Pharmacol Ther. 2013 Jan;37(2):214-24. doi: 10.1111/apt.12159. Epub 2012 Nov 28.
7
Risk factors for postoperative intra-abdominal septic complications after bowel resection in patients with Crohn's disease.克罗恩病患者肠切除术后腹腔内感染性并发症的术后危险因素。
Dis Colon Rectum. 2012 Sep;55(9):957-62. doi: 10.1097/DCR.0b013e3182617716.
8
Anti-tumor necrosis factor and postoperative complications in Crohn's disease: systematic review and meta-analysis.抗肿瘤坏死因子与克罗恩病术后并发症:系统评价与荟萃分析。
Inflamm Bowel Dis. 2012 Dec;18(12):2404-13. doi: 10.1002/ibd.22954. Epub 2012 Mar 29.
9
Determinants for postoperative complications after laparoscopic intestinal resection for Crohn's disease.腹腔镜肠切除术治疗克罗恩病术后并发症的决定因素。
Surg Endosc. 2012 Apr;26(4):933-8. doi: 10.1007/s00464-011-1970-0. Epub 2011 Oct 15.
10
Surgical resection in Crohn's disease: is immunosuppressive medication associated with higher postoperative infection rates?克罗恩病的手术切除:免疫抑制药物是否与更高的术后感染率相关?
Colorectal Dis. 2011 Nov;13(11):1294-8. doi: 10.1111/j.1463-1318.2010.02469.x.

克罗恩病术后早期并发症的预测参数:单团队经验

Predictive parameters of early postoperative complications in Crohn's disease: Single team experience.

作者信息

Atasoy Deniz, Aghayeva Afag, Bilgin İsmail Ahmet, Erzin Yusuf, Bayraktar İlknur Erenler, Baca Bilgi, Karahasanoğlu Tayfun, Hamzaoğlu İsmail

机构信息

Department of General Surgery, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey.

Department of Gastroenterology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.

出版信息

Turk J Gastroenterol. 2018 Jul;29(4):406-410. doi: 10.5152/tjg.2018.17687.

DOI:10.5152/tjg.2018.17687
PMID:30249554
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6284636/
Abstract

BACKGROUND/AIMS: Most of the patients with Crohn's disease (CD) may require at least one surgical procedure over their lifetime. However, these patients tend to have a high incidence of postoperative complications. The aim of this retrospective study was to investigate the predictive parameters of postoperative complications in CD.

MATERIALS AND METHODS

All consecutive patients with CD between March 2001 and March 2016 who underwent bowel resection were included to this study. Postoperative complications were divided as; major complications including anastomotic leakage, ostomy complications, acute mechanical intestinal obstruction and hemorrhage, and minor complications including wound infection.

RESULTS

A total of 147 patients (74 females, 73 males) with a mean age of 36±11.9 years met the inclusion criteria. Behaviors of CD were stricturing in 90 (62%), fistulizing in 45 (30%) and inflammatory in 12 (8%) patients. Minimally invasive approach was applied in 35% (n=51) of the patients. Twentysix (17%) patients had early (≤30 days) postoperative surgical complications including anastomotic leak (n=10), intra-abdominal bleeding (n=2), complications related to ostomy (n=2), acute mechanical intestinal obstruction (n=1) and wound infection (n=11). Only fistulizing disease behavior was associated with early postoperative complications (p=0.014).

CONCLUSION

This study suggests that postoperative complications are still more common in fistulizing CD. Surgical approach did not affect the complication rate. The decision should be individualized according to the prominent risk factors and surgeons' preference.

摘要

背景/目的:大多数克罗恩病(CD)患者在其一生中可能至少需要接受一次外科手术。然而,这些患者术后并发症的发生率往往较高。本回顾性研究的目的是探讨CD患者术后并发症的预测参数。

材料与方法

本研究纳入了2001年3月至2016年3月期间所有连续接受肠切除术的CD患者。术后并发症分为:主要并发症包括吻合口漏、造口并发症、急性机械性肠梗阻和出血,以及次要并发症包括伤口感染。

结果

共有147例患者(74例女性,73例男性)符合纳入标准,平均年龄为36±11.9岁。CD的行为表现为狭窄型90例(62%)、瘘管型45例(30%)和炎症型12例(8%)。35%(n = 51)的患者采用了微创方法。26例(17%)患者术后早期(≤30天)出现手术并发症,包括吻合口漏(n = 10)、腹腔内出血(n = 2)、造口相关并发症(n = 2)、急性机械性肠梗阻(n = 1)和伤口感染(n = 11)。只有瘘管型疾病行为与术后早期并发症相关(p = 0.014)。

结论

本研究表明,瘘管型CD患者术后并发症仍然更为常见。手术方式并未影响并发症发生率。应根据突出的危险因素和外科医生的偏好进行个体化决策。