导航过渡时期：儿童炎症性肠病的多学科方法。
Navigating the transition: a multidisciplinary approach to inflammatory bowel disease in children.
机构信息
Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, Pavia, Italy.
Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
出版信息
Pediatr Surg Int. 2024 Aug 27;40(1):245. doi: 10.1007/s00383-024-05789-8.
PURPOSE
A multidisciplinary approach to Inflammatory Bowel Disease (IBD) has recently demonstrated a positive impact in pediatric patients, reducing dropout rates and facilitating the transition to adult care. Our study aims to evaluate how this approach influences disease activity, dropout rates, and transition.
METHODS
We conducted a longitudinal observational study including all patients diagnosed with IBD during pediatric-adolescent age, with a minimum follow-up period of 12 months. For each patient, endpoints included therapeutic approach, need for surgery and transition features.
RESULTS
We included 19 patients: 13 with Ulcerative Colitis (UC) and 6 with Crohn's disease (CD). Most patients required multiple lines of therapy, with over 50% in both groups receiving biological drugs. Compliance was good, with a single dropout in each group (10, 5%). The need for surgery was significantly higher in the CD group compared to the UC group (16% vs. 7.7%, p < 0.01). Mean age at transition was significantly higher in the UC group compared to the CD group (19.2 ± 0.7 years SD vs. 18.3 ± 0.6 years SD, p < 0.05).
CONCLUSIONS
In our experience, the multidisciplinary approach to IBD in transition-age patients appears effective in achieving clinical remission, offering the potential to reduce therapeutic dropouts.
目的
多学科方法治疗炎症性肠病（IBD）最近在儿科患者中显示出积极的影响，降低了辍学率，并促进了向成人护理的过渡。我们的研究旨在评估这种方法如何影响疾病活动、辍学率和过渡。
方法
我们进行了一项纵向观察性研究，包括所有在儿童期和青少年期诊断为 IBD 的患者，随访时间至少为 12 个月。对于每个患者，终点包括治疗方法、手术需求和过渡特征。
结果
我们纳入了 19 名患者：13 名溃疡性结肠炎（UC）患者和 6 名克罗恩病（CD）患者。大多数患者需要多种治疗方法，两组中超过 50%的患者接受了生物药物治疗。依从性良好，两组均有一名患者辍学（10%，5%）。与 UC 组相比，CD 组的手术需求明显更高（16%比 7.7%，p<0.01）。与 CD 组相比，UC 组的过渡年龄明显更高（19.2±0.7 岁 SD 比 18.3±0.6 岁 SD，p<0.05）。
结论
在我们的经验中，过渡年龄患者的 IBD 多学科方法似乎在实现临床缓解方面是有效的，有可能减少治疗辍学。
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