切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2018, Vol. 07 ›› Issue (02) : 109 -112. doi: 10.3877/cma.j.issn.2095-3224.2018.02.002

所属专题: 文献

专家论坛

克罗恩病围手术期处理要点
郭振1, 朱维铭1,()   
  1. 1. 南京 210000,中国人民解放军南京总医院普通外科
  • 收稿日期:2017-05-11 出版日期:2018-04-25
  • 通信作者: 朱维铭

Main points of perioperative management for Crohn′s disease

Zhen Guo1, Weiming Zhu1,()   

  1. 1. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210000, China
  • Received:2017-05-11 Published:2018-04-25
  • Corresponding author: Weiming Zhu
  • About author:
    Corresponding author: Zhu Weiming, Email:
引用本文:

郭振, 朱维铭. 克罗恩病围手术期处理要点[J/OL]. 中华结直肠疾病电子杂志, 2018, 07(02): 109-112.

Zhen Guo, Weiming Zhu. Main points of perioperative management for Crohn′s disease[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(02): 109-112.

虽然克罗恩病药物治疗发展迅速,但手术仍是缓解克罗恩病临床症状的主要手段之一。克罗恩病手术术后并发症发生率及术后疾病复发率均较高,极大影响了手术的效果。以消除或减少并发症/复发危险因素为目的或以并发症/复发危险因素为导向的综合性、个体化的克罗恩病围手术期治疗对于提高手术安全性,延长术后疾病缓解时间具有重要意义。

Despite improvements in medical care, surgery remains the main treatment for Crohn′s disease. Postoperative complications and postoperative recurrence are seen frequently in patients who undergoing surgery for Crohn′s disease, which negatively affected the effect of surgery. Comprehensive, individualized perioperative strategies with the purpose of eliminating or reducing risk factors for postoperative complications/recurrence could potentially improve short-term surgical outcomes and reduce postoperative recurrence.

[1]
郑家驹,史肖华,竺霞霜, 等. 我国克罗恩病不同年代发病率及患病率的比较 [J]. 中华内科杂志, 2011, 50(7): 597-600.
[2]
Frolkis AD, Dykeman J, Negron ME, et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies [J]. Gastroenterology, 2013, 145(5): 996-1006.
[3]
Fumery M, Seksik P, Auzolle C, et al. Postoperative Complications after Ileocecal Resection in Crohn′s Disease: A Prospective Study From the REMIND Group [J]. American Journal of Gastroenterology, 2017, 112(2): 337.
[4]
Regueiro M, Velayos F, Greer J B, et al. American Gastroenterological Association Institute Technical Review on the Management of Crohn′s Disease After Surgical Resection [J]. Gastroenterology, 2017, 152(1): 277.
[5]
Buisson A, Chevaux JB, Allen PB, et al. Review article: the natural history of postoperative Crohn′s disease recurrence [J]. Alimentary Pharmacology & Therapeutics, 2012, 35(6):625-633.
[6]
Patel KV, Darakhshan AA, Griffin N, et al. Patient optimization for surgery relating to Crohn′s disease [J]. Nat Rev Gastroenterol Hepatol, 2016, 13(12): 707-719.
[7]
Regueiro M, Strong S A, Ferrari L, et al. Postoperative Medical Management of Crohn′s Disease: Prevention and Surveillance Strategies [J]. Journal of Gastrointestinal Surgery, 2016, 20(8): 1415.
[8]
Braithwaite KA, Alazraki AL.Use of the star sign to diagnose internal fistulas in pediatric patients with penetrating Crohn disease by MR enterography [J]. Pediatric radiology, 2014, 44(8): 926-931.
[9]
Guo Z, Guo D, Gong J, et al. Preoperative Nutritional Therapy Reduces the Risk of Anastomotic Leakage in Patients with Crohn′s Disease Requiring Resections [J]. Gastroenterology Research & Practice, 2016, 2016: 5017856.
[10]
Li Y, Zuo L, Zhu W, et al. Role of exclusive enteral nutrition in the preoperative optimization of patients with Crohn′s disease following immunosuppressive therapy [J]. Medicine, 2015, 94(5): e478.
[11]
Jacobson S. Early postoperative complications in patients with Crohn′s disease given and not given preoperative total parenteral nutrition [J]. Scandinavian Journal of Gastroenterology, 2012, 47(2): 170-177.
[12]
曹磊,李毅,龚剑峰, 等. 克罗恩病合并腹腔脓肿临床路径应用分析 [J]. 中国实用外科杂志, 2016, 36(11): 1211-1214.
[13]
Møller A, Tønnesen H. Risk reduction: Perioperative smoking intervention [J]. Best Practice & Research Clinical Anaesthesiology, 2006, 20(2): 237-248.
[14]
Warner DO. Helping surgical patients quit smoking: why, when, and how [J]. Anesthesia & Analgesia, 2005, 101(2): 481-487.
[15]
Subramanian V, Saxena S, Kang JY, et al. Preoperative steroid use and risk of postoperative complications in patients with inflammatory bowel disease undergoing abdominal surgery. [J]. American Journal of Gastroenterology, 2008, 103(103): 2373-2381.
[16]
Tzivanakis A, Singh JC, Guy RJ, et al. Influence of risk factors on the safety of ileocolic anastomosis in Crohn′s disease surgery [J]. Diseases of the Colon & Rectum, 2012, 55(5): 558-562.
[17]
Billioud V, Ford AC, Tedesco ED, et al. Preoperative use of anti-TNF therapy and postoperative complications in inflammatory bowel diseases: A meta-analysis [J]. 2013, 7(11): 853-867.
[18]
Yi L, Stocchi L, Rui Y, et al. Perioperative Blood Transfusion and Postoperative Outcome in Patients with Crohn′s Disease Undergoing Primary Ileocolonic Resection in the "Biological Era" [J]. Journal of Gastrointestinal Surgery, 2015, 19(10): 1842-1851.
[19]
Zhu W, Guo Z, Zuo L, et al. CONSORT: Different End-Points of Preoperative Nutrition and Outcome of Bowel Resection of Crohn Disease: A Randomized Clinical Trial [J]. Medicine, 2015, 94(29): e1175.
[20]
Sangster W, Berg AS, Choi CS, et al. Outcomes of early ileocolectomy after percutaneous drainage for perforated ileocolic Crohn′s disease [J]. American Journal of Surgery, 2016, 212(4): 728-734.
[21]
李毅,朱维铭,龚剑峰, 等. 术后C反应蛋白水平对克罗恩病术后腹腔感染性并发症的预测诊断价值 [J]. 中华外科杂志, 2016, 54(8): 620-623.
[22]
Nguyen GC, Jr LE, Hirano I, et al. American Gastroenterological Institute Guideline on the Management of Crohn′s Disease After Surgical Resection [J]. Gastroenterology, 2017, 152(1): 271-275.
[23]
Zhu W, Li Y, Gong J, et al. Tripterygium wilfordii Hook. f. versus azathioprine for prevention of postoperative recurrence in patients with Crohn′s disease: a randomized clinical trial [J]. Dig Liver Dis, 2015, 47(1): 14-19.
[24]
Cruz PD, Kamm MA, Hamilton AL, et al. Crohn′s disease management after intestinal resection: a randomised trial [J]. Lancet, 2014, 385(9976): 1406-1417.
[1] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[2] 刘世君, 马杰, 师鲁静. 胃癌完整系膜切除术+标准D2根治术治疗进展期胃癌的近中期随访研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 27-30.
[3] 杨建波, 马欢, 黄小梅, 刘华柱. 结肠镜辅助下EMR、CSP和RFA术治疗直径<1cm结直肠息肉的疗效和安全性比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 76-79.
[4] 谢田伟, 庞于樊, 吴丽. 超声引导下不同消融术对甲状腺良性结节体积缩减率、复发率的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 80-83.
[5] 张朝军, 袁新普. 腹腔镜辅助低位直肠癌根治术[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 602-602.
[6] 李伟, 宋子健, 赖衍成, 周睿, 吴涵, 邓龙昕, 陈锐. 人工智能应用于前列腺癌患者预后预测的研究现状及展望[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 541-546.
[7] 皮尔地瓦斯·麦麦提玉素甫, 李慧灵, 艾克拜尔·艾力, 李赞林, 王志, 克力木·阿不都热依木. 生物补片修补巨大复发性腹壁切口疝临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 624-628.
[8] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[9] 焦振东, 惠鹏, 金上博. 三维可视化结合ICG显像技术在腹腔镜肝切除术治疗复发性肝癌中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 859-864.
[10] 董晓斌, 张静, 苏莎莎, 莎比亚·沙吾提, 盛好. 溃疡性结肠炎患者相关环状RNA 差异表达谱分析及功能研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 499-509.
[11] 关国欣, 罗福文. 结肠癌合并急性梗阻的个性化处理[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 459-463.
[12] 丁亚琴, 方旭, 戴彦成. 基于紧密型医联体的“一免三优先政策”在基层消化道肿瘤筛查中的应用探讨[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 481-484.
[13] 刘郁, 段绍斌, 丁志翔, 史志涛. miR-34a-5p 在结肠癌患者的表达及其与临床特征及预后的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 485-490.
[14] 刘福成, 赵欣, 乔海朋, 刘晓峰, 张翀, 张宗明. 保留左结肠动脉的肠系膜下动脉根部淋巴结清扫对腹腔镜直肠癌根治术的疗效影响[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 647-653.
[15] 郭曌蓉, 王歆光, 刘毅强, 何英剑, 王立泽, 杨飏, 汪星, 曹威, 谷重山, 范铁, 李金锋, 范照青. 不同亚型乳腺叶状肿瘤的临床病理特征及预后危险因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 524-532.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?