Simonowitz D A
West J Med. 1980 Jan;132(1):1-6.
The natural history of Crohn disease* is varied and unpredictable, and its cause is not known. No modality of treatment has definitely been shown to alter its course. Surgical treatment was carried out in a consistent fashion in 141 consecutive patients with Crohn disease. The indications for surgical operation were the complications of the disease only; these included fistula, abscess, obstruction and hemorrhage. Preoperative evaluation included upper gastrointestinal examination, barium enema, intravenous pyelogram, proctoscopy, and nutritional and volume support. In 76 of these patients previous operations had been carried out for Crohn disease. The surgical treatment was based upon the specific complication present, with adherence to the principle of resection of diseased tissue only. Ureterolysis also was necessary in 20 percent of these patients. The operative mortality was 1.4 percent, postoperative complications occurred in 54 patients and the surgical recurrence rate was 26 percent. A favorable result was accomplished in 85 percent of the patients.
克罗恩病的自然病程多样且不可预测，其病因不明。尚无确切证据表明哪种治疗方式能改变其病程。对141例连续性克罗恩病患者进行了一致的外科治疗。手术指征仅为疾病并发症，包括瘘管、脓肿、梗阻和出血。术前评估包括上消化道检查、钡灌肠、静脉肾盂造影、直肠镜检查以及营养和容量支持。其中76例患者此前因克罗恩病接受过手术。手术治疗基于存在的特定并发症，仅遵循切除病变组织的原则。20%的患者还需要进行输尿管松解术。手术死亡率为1.4%，54例患者出现术后并发症，手术复发率为26%。85%的患者取得了良好效果。
