克罗恩病的外科治疗

Jun-lin Li, Shao-liang Han
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引用次数: 0

摘要

目的探讨克罗恩病的手术指征和手术方法。方法回顾性分析47例克罗恩病患者的临床资料。结果主要临床表现为腹痛35例、腹泻16例、消瘦乏力12例、腹部肿块9例、肠梗阻31例、肠粘连18例、肠穿孔8例、肠出血11例、内瘘4例、腹腔脓肿4例。术前肠镜检查23例,其中7例诊断为克罗恩病。手术方法包括结肠切除术15例,小肠切除和肠粘连松解术29例,回肠造口术3例。术后并发症13例,其中切口裂开2例,肠瘘5例,应激性溃疡2例,肺部感染1例,短肠综合征1例,术后早期炎症性肠梗阻2例,死亡1例。对44例患者进行了随访,平均随访6.8年。克罗恩病复发11例,癌变3例。结论手术仍是克罗恩病的主要治疗手段,密切随访对克罗恩病复发和癌变具有重要意义。关键词:克罗恩病;外科手术;并发症
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical treatment of Crohn disease
Objective To investigate the surgical indication and surgical procedures for Crohn disease. Methods Clinical data of 47 cases with Crohn disease were retrospectively analyzed. Results The main clinical manifestations were abdominal pain ( 35 cases), diarrhea (16 cases), emaciation and fatigue( 12 cases), abdominal mass (9 cases), intestinal obstruction (31 cases), intestinal adhesion (18 cases), intestinal perforation( 8 cases), intestinal bleeding ( 11 cases) , internal fistula ( 4 cases), abdominal abscess( 4 cases). Preoperative enteroscopy was performed in 23 cases, and 7 cases were diagnosed as Crohn′s disease. Operative procedures included colectomy in 15 cases, small bowel resection and intestinal adhesion lysis in 29 cases, ileostomy in 3 cases. Postoperative complications occurred in 13 cases, including incision dehiscence in 2 cases, intestinal fistula in 5 cases, there were 2 cases of stress ulcer, pulmonary infection in 1 case and short bowel syndrome in 1 case, early postoperative inflammatory bowel obstruction in 2 cases and death in 1 case. 44 patients were followed-up, for an average of 6.8 years. Recurrence of Crohn′s disease was found in 11 cases and canceration in 3 cases. Conclusions Surgery is still the mainstay for Crohn′s disease, and close follow-up is important for disease recurrence and canceration. Key words: Crohn disease; Surgical procedures, operative; Complications
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