Lan Nan, Wu Xianrui, Shen Bo
Center for Inflammatory Bowel Disease, Columbia University Irving Medical Center/NewYork Presbyterian Hospital, New York, NY, USA.
Department of Colorectal Surgery, The 6th Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China.
Gastroenterol Rep (Oxf). 2023 Mar 25;11:goac085. doi: 10.1093/gastro/goac085. eCollection 2023.
Patients with Crohn's disease frequently suffer from fistula resulting from adverse sequelae of persistent complicated active disease or surgical intervention. Fistula affects a patient's quality of life and is directly associated with the need for surgical intervention. Diagnosis of fistula can be made through CT enterography, MR enterography, gastrograffin-based imaging, and transanal ultrasound. Treatment for fistula mainly consists of medication, endoscopic procedures, and surgery. There are emerging approaches under current investigation, such as stem cell therapy. The results showed a decent response in patients with perianal and rectovaginal fistula with minimal side effects. Further investigation is still needed for other internal fistula.
克罗恩病患者常因持续性复杂活动性疾病的不良后遗症或手术干预而出现瘘管。瘘管会影响患者的生活质量，且与手术干预的必要性直接相关。瘘管的诊断可通过CT小肠造影、磁共振小肠造影、泛影葡胺造影成像及经肛门超声检查来进行。瘘管的治疗主要包括药物治疗、内镜治疗及手术治疗。目前正在研究一些新的治疗方法，如干细胞疗法。结果显示，肛周瘘管和直肠阴道瘘管患者对此疗法反应良好，且副作用极小。对于其他内瘘管，仍需进一步研究。
