Hamon J F, Carbonnel F, Beaugerie L, Sezeur A, Gallot D, Malafosse M, Parc R, Gendre J P, Cosnes J
Service d'Hépato-Gastroentérologie, Hôpital Rothschild, Paris.
Gastroenterol Clin Biol. 1998 Jun-Jul;22(6-7):601-6.
To evaluate the influence of the indication of the first surgical procedure on the prognosis of Crohn's disease.
We compared retrospectively the long-term course of 179 patients operated on for a perforating disease and 322 patients operated on for a nonperforating disease. Mean follow-up was 11 years and 2 months in the two groups.
Forty of 179 (25%) and 106 of 322 (33%) patients with perforating and nonperforating diseases underwent a second intestinal resection, respectively. The patients who had been operated on for a perforating disease were significantly more often reoperated on for the same indication, and conversely. Patients with perforating diseases experienced less second resections (actuarial rates: 37 +/- 11% vs 51 +/- 8% at ten years respectively), less post-surgical handicaps (mean index 24.9 vs 27.9), and fewer patients required immunosuppressive drugs (25 vs 35%).
Long-term prognosis of perforating Crohn's disease does not appear to be more severe than that of nonperforating disease.
评估首次手术指征对克罗恩病预后的影响。
我们回顾性比较了179例因穿孔性疾病接受手术的患者和322例因非穿孔性疾病接受手术的患者的长期病程。两组的平均随访时间为11年零2个月。
179例穿孔性疾病患者中有40例（25%）、322例非穿孔性疾病患者中有106例（33%）分别接受了第二次肠道切除术。因穿孔性疾病接受手术的患者因相同指征再次手术的频率明显更高，反之亦然。穿孔性疾病患者接受二次切除的次数较少（十年精算率分别为37±11%和51±8%），术后残疾较少（平均指数24.9对27.9），需要免疫抑制药物的患者也较少（25%对35%）。
穿孔性克罗恩病的长期预后似乎并不比非穿孔性疾病更严重。
