肠瘘性克罗恩病内科与外科治疗的疗效分析。

IF 2.6 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES
PLoS ONE Pub Date : 2025-07-17 eCollection Date: 2025-01-01 DOI:10.1371/journal.pone.0327784
Pingrun Chen, Yufen She, Liangfang Wang, Yina Li, Yan Zhang
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引用次数: 0

摘要

背景:克罗恩病(CD)的肠穿透并发症是一个具有挑战性的问题,但很难决定是药物治疗还是手术治疗。本研究旨在评价内科和外科治疗非肛周瘘管性CD患者的效果。目的:本研究旨在评价和比较手术和内科治疗非肛周瘘管性CD患者的疗效。材料和方法:本回顾性研究包括所有合并非肛周瘘的CD患者。我们评估了内科和外科治疗的结果。通过影像学检查或超声检查确定瘘管闭合。随后进行Cox回归分析。结果:共纳入60例患者,其中男性37例。43.3%的患者首次使用生物制剂,55%的患者需要手术作为初始治疗,其余1例患者单独使用硫唑嘌呤。71.7%的患者实现了瘘管闭合,中位随访时间为32个月。在接受生物制剂作为初始治疗的患者中,38.5%的患者无需手术即可完成瘘管闭合,50%的患者进行了手术。69.7%的患者采用手术作为初始治疗。初始治疗前肠内营养与瘘管闭合独立相关。结论:在非肛周瘘管性CD的治疗中,手术固然重要,但生物制剂同样有效。肠内营养可能会增加瘘管闭合的可能性,特别是在接受手术作为初始治疗的患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Outcomes of medical and surgical treatment for intestinal fistulizing Crohn's disease.

Outcomes of medical and surgical treatment for intestinal fistulizing Crohn's disease.

Outcomes of medical and surgical treatment for intestinal fistulizing Crohn's disease.

Outcomes of medical and surgical treatment for intestinal fistulizing Crohn's disease.

Background: Intestinal penetrating complications of Crohn's disease (CD) are challenging issues, but it is difficult to decide between medical treatment and surgery. This study aimed to evaluate the outcomes of medical and surgical therapy in patients with non-perianal fistulizing CD.

Objective: Our study aimed to evaluate and compare the effectiveness of surgery and medical treatment in CD patients with non-perianal fistulas.

Materials and methods: This retrospective study included all CD patients with non-perianal fistulas. We evaluated the outcomes of medical and surgical therapy. Fistula closure was identified with radiological examinations or ultrasound. Cox regression analysis was subsequently performed.

Results: Sixty patients (37 male) were included. 43.3% of the patients received biological agents as the first therapy, whereas 55% required surgery as the initial therapy, and the remaining 1 patient received azathiopurine alone. 71.7% of the patients achieved fistula closure, with a median follow-up of 32 months. Among the patients who received biologics as the initial treatment, 38.5% achieved fistula closure without the need for surgery, and 50% of the patients underwent surgery. Fistula closure was observed in 69.7% of the patients who underwent surgery as the initial treatment. Enteral nutrition before initial treatment was independently associated with fistula closure.

Conclusion: Although surgery occupies a crucial role in the treatment of patients with non-perianal fistulizing CD, biologics are also effective. Enteral nutrition may increase the probability of fistula closure, especially in patients who undergo surgery as the initial therapy.

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来源期刊
PLoS ONE
PLoS ONE 生物-生物学
CiteScore
6.20
自引率
5.40%
发文量
14242
审稿时长
3.7 months
期刊介绍: PLOS ONE is an international, peer-reviewed, open-access, online publication. PLOS ONE welcomes reports on primary research from any scientific discipline. It provides: * Open-access—freely accessible online, authors retain copyright * Fast publication times * Peer review by expert, practicing researchers * Post-publication tools to indicate quality and impact * Community-based dialogue on articles * Worldwide media coverage
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