Yang Shan-Bing, Du Shu-Wen, Wang Ji-Heng
Department of Gastroenterology, the Seventh Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100700, China.
World J Clin Cases. 2020 Jul 6;8(13):2769-2777. doi: 10.12998/wjcc.v8.i13.2769.
Patients affected by Crohn's disease (CD) are more likely to develop gastrointestinal stenosis and often undergo surgery during the duration of disease.
To identify the risk factors for gastrointestinal stenosis in hospitalized CD patients in China.
The clinical data of CD patients hospitalized at the Seventh Medical Center, Chinese People's Liberation Army General Hospital from January 2010 to December 2018 were included. Patients with gastrointestinal stenosis were compared to those without gastrointestinal stenosis for clinical variables. The risk factors for gastrointestinal stenosis were identified using univariate and multivariable logistic regression analyses. The treatments for patients with gastrointestinal stenosis were analyzed, and the characteristics of different treatment methods were discussed.
The incidence of gastrointestinal stenosis was 59.02% in the 122 hospitalized CD patients. Age of onset of more than 40 years (odds ratio [OR] = 3.072, 95% confidence interval [CI]: 1.298-7.272, = 0.009) and duration of disease of more than 5 years (OR = 2.101, 95%CI: 1.002-4.406, = 0.048) were associated with the occurrence of gastrointestinal stenosis. Fifteen (20.83%) patients did not undergo surgery and received internal medicine and nutrition treatment. Surgical treatments were performed in 72.22% (52) of cases. The rate of postoperative complications was 15.38% (8 cases), and during a median follow-up period of 46 mo, 11.54% (6 cases) underwent reoperation. A total of 29.17% (21 cases) were treated with endoscopic therapy, and during a median follow-up period of 32 mo, 76.19% (16 cases) had no surgical event, 23.81% (5 cases) failed to avoid surgical treatments, and no serious postoperative complications occurred after endoscopic therapy.
Age of onset of more than 40 years and duration of disease of more than 5 years may be strongly correlated with a higher risk of gastrointestinal stenosis in hospitalized CD patients. Endoscopic therapy for gastrointestinal stenosis is relatively safe and effective, and may help to prevent or delay surgery.
克罗恩病（CD）患者更易发生胃肠道狭窄，且在疾病过程中常需接受手术治疗。
确定中国住院CD患者发生胃肠道狭窄的危险因素。
纳入2010年1月至2018年12月在中国人民解放军总医院第七医学中心住院的CD患者的临床资料。将有胃肠道狭窄的患者与无胃肠道狭窄的患者进行临床变量比较。采用单因素和多因素logistic回归分析确定胃肠道狭窄的危险因素。分析胃肠道狭窄患者的治疗情况，并探讨不同治疗方法的特点。
122例住院CD患者中胃肠道狭窄的发生率为59.02%。发病年龄超过40岁（比值比[OR]=3.072，95%置信区间[CI]：1.298 - 7.272，P = 0.009）和病程超过5年（OR = 2.101，95%CI：1.002 - 4.406，P = 0.048）与胃肠道狭窄的发生相关。15例（20.83%）患者未接受手术，接受内科和营养治疗。72.22%（52例）的病例进行了手术治疗。术后并发症发生率为15.38%（8例），中位随访期46个月时，11.54%（6例）接受了再次手术。29.17%（21例）接受了内镜治疗，中位随访期32个月时，76.19%（16例）未发生手术事件，23.81%（5例）未能避免手术治疗，内镜治疗后未发生严重术后并发症。
发病年龄超过40岁和病程超过5年可能与住院CD患者发生胃肠道狭窄的较高风险密切相关。胃肠道狭窄的内镜治疗相对安全有效，可能有助于预防或延迟手术。
