Fasth S, Hellberg R, Hultén L, Magnusson O
Acta Chir Scand. 1980;146(7):519-26.
Early postoperative mortality and morbidity and factors that might be of importance in this respect were studied in a series of consecutive patients resected for classical Crohn's disease (IPI) or mainly colonic disease (CPC). The operative mortality was comparatively low after surgery for both primary and recurrent disease (1.5 and 2.0% respectively). The complication rate was marked, particularly so after primary surgery for colonic disease. Weight loss, abnormally low serum albumin or TIBC referred to as nutritional markers, appeared to have no predictive value in determining patients at risk for postoperative complications. Steroid treatment prior to operation was not associated with increased postoperative complication rate. The important factor influencing postoperative complication rate was the occurrence of preoperative septic complications and surgery performed for urgency was associated with an increased complication rate only when associated with pre-existing septic complications. The observations would appear to speak in favour of surgery at an earlier stage in patients with Crohn's disease who do not respond to medical treatment.
在一系列因经典型克罗恩病(IPI)或主要为结肠疾病(CPC)而接受手术切除的连续患者中,研究了术后早期死亡率和发病率以及在此方面可能重要的因素。原发性疾病和复发性疾病手术后的手术死亡率相对较低(分别为1.5%和2.0%)。并发症发生率较高,尤其是结肠疾病初次手术后。体重减轻、血清白蛋白或总铁结合力异常低,即所谓的营养指标,在确定术后并发症风险患者方面似乎没有预测价值。术前使用类固醇治疗与术后并发症发生率增加无关。影响术后并发症发生率的重要因素是术前感染性并发症的发生,而急诊手术仅在伴有既往感染性并发症时才与并发症发生率增加有关。这些观察结果似乎支持对药物治疗无反应的克罗恩病患者在更早阶段进行手术。