Gooszen H G, Silvis R
Department of Surgery, University Hospital of Utrecht, Netherlands.
Neth J Med. 1994 Aug;45(2):65-71.
In order to determine the effect of perioperative blood transfusions (BT) on the recurrence of Crohn's disease after primary surgery we reviewed the medical histories of 148 patients with Crohn's disease, 62 males and 86 females (49 non-parous and 37 parous females). Eighty-seven patients received perioperative BT. Overall, perioperative BT showed no effect on recurrence. Patients with Crohn's disease limited to the ileum had a better prognosis with regard to recurrence than patients with Crohn's disease located in the colon or located in both ileum and colon, but this was not significant. Perioperative transfusion seemed to protect against recurrent disease after colon resection, which might be explained by the fact that colon resections, which often necessitate perioperative BT, generally result in a shorter bowel segment at risk for recurrent disease. Overall, parous females showed a worse prognosis than non-parous females and males (p = 0.022). Transfusions had a beneficial effect in parous females (p = 0.068) and after correction for type of operation this beneficial effect was significant (p = 0.026). After perioperative BT parous females had a similar prognosis regarding recurrent Crohn's disease to that of non-parous females and males.
为了确定围手术期输血(BT)对克罗恩病初次手术后复发的影响,我们回顾了148例克罗恩病患者的病历,其中男性62例,女性86例(49例未生育女性和37例已生育女性)。87例患者接受了围手术期输血。总体而言,围手术期输血对复发无影响。局限于回肠的克罗恩病患者在复发方面的预后优于病变位于结肠或同时累及回肠和结肠的患者,但差异无统计学意义。围手术期输血似乎可预防结肠切除术后疾病复发,这可能是因为结肠切除通常需要围手术期输血,而这通常会使复发风险的肠段较短。总体而言,已生育女性的预后比未生育女性和男性差(p = 0.022)。输血对已生育女性有有益作用(p = 0.068),校正手术类型后,这种有益作用具有统计学意义(p = 0.026)。围手术期输血后,已生育女性在克罗恩病复发方面的预后与未生育女性和男性相似。