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 ›› 2020, Vol. 09 ›› Issue (03) : 226 -230. doi: 10.3877/cma.j.issn.2095-3224.2020.03.003

所属专题: 文献

专家论坛

乙状结肠憩室炎的诊疗现状及进展
雷程1, 吴斌2,()   
  1. 1. 830011 乌鲁木齐,新疆医科大学第三临床医学院(附属肿瘤医院)胃肠外科
    2. 100730 北京,中国医学科学院北京协和医学院 北京协和医院基本外科
  • 收稿日期:2020-03-18 出版日期:2020-06-25
  • 通信作者: 吴斌
  • 基金资助:
    中国医学科学院医学与健康科技创新工程(No.2017-I2M-1-009)

The present situation and progress in diagnosis and treatment of sigmoid diverticulitis

Cheng Lei1, Bin Wu2,()   

  1. 1. Department of Gastrointestinal Surgery, the Third Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi 830011, China
    2. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2020-03-18 Published:2020-06-25
  • Corresponding author: Bin Wu
  • About author:
    Corresponding author: Wu Bin, Email:
引用本文:

雷程, 吴斌. 乙状结肠憩室炎的诊疗现状及进展[J/OL]. 中华结直肠疾病电子杂志, 2020, 09(03): 226-230.

Cheng Lei, Bin Wu. The present situation and progress in diagnosis and treatment of sigmoid diverticulitis[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(03): 226-230.

结肠憩室炎是指结肠憩室的炎症性疾病,好发于乙状结肠。乙状结肠憩室炎的发生与年龄、低纤维饮食及结肠动力紊乱有一定联系,临床上可有左下腹痛、发热、膀胱刺激征甚至梗阻表现。乙状结肠憩室炎主要依据CT检查来进行疾病分级,并采用相应的治疗手段,包括饮食控制、抗生素治疗、脓肿穿刺引流以及手术治疗等。本文将梳理乙状结肠憩室炎的临床诊疗现状及进展,以期协助临床医生更好地认识疾病和规范治疗。

Colonic diverticulitis is an inflammatory disease of the colonic diverticulum, which is more common in the sigmoid colon. Sigmoid diverticulitis is associated with age, a low-fiber diet, and colonic motility disorders. Patients may have clinical symptoms such as left lower abdominal pain, fever, bladder irritation, and even obstruction. Sigmoid diverticulitis is mainly classified based on CT examination. Current treatments include diet control, antibiotic treatment, abscess puncture and drainage, and surgery. This review aims to summarize the current status and progress in the diagnosis and treatment of sigmoid diverticulitis in order to help clinicians better understand and standardize the treatment of the disease.

表1 乙状结肠憩室炎穿孔分级评分
图1 结肠憩室炎的诊疗流程图[16]
[1]
Binda GA, Cuomo R, Laghi A, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines [J]. Tech in Coloproctol, 2015, 19(10): 615-626.
[2]
Aldoori WH, Giovannucci EL, Rimm EB, et al. A prospective study of diet and the risk of symptomatic diverticular disease in men[J]. Am J Clin Nutr, 1994, 60(5): 757-764.
[3]
Painter NS, Truelove SC, Ardran GM, et al. Segmentation and the localization of intraluminal pressure in the human colon, with special reference to the pathogenesis of colonic diverticula [J]. Gastroenterology, 1968, 54(4):Suppl: 778-780.
[4]
Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis [J]. Gastroenterology, 2019, 156(5): 1282-1298.
[5]
Peery AF, Keku TO, Martin CF, et al. Distribution and characteristics of colonic diverticula in a united states screening population [J]. Clin Gastroenterol Hepatol, 2016, 14(7): 980-985.
[6]
de Korte N, Unlü C, Boermeester MA, et al. Use of antibiotics in uncomplicated diverticulitis [J]. Br J Surg, 2011, 98(6): 761-767.
[7]
Thornton E, Morrin MM, Yee J. Current status of MR colonography [J]. Radiographics, 2010, 30(1): 201-218.
[8]
Sallinen V, Mentula P, Leppäniemi A. Risk of colon cancer after computed tomography-diagnosed acute diverticulitis: is routine colonoscopy necessary? [J]. Surg Endosc, 2014, 28(3): 961-966.
[9]
Moore FA, Catena F, Moore EE, et al. Position paper: Management of perforated sigmoid diverticulitis [J]. World J Emerg Surg, 2013, 8(1): 55.
[10]
Chabok A, Pahlman L, Hjern F, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis [J]. Br J Surg, 2012, 99(4): 532-539.
[11]
Shabanzadeh DM, Wille-Jørgensen P. Antibiotics for uncomplicated diverticulitis [J]. Cochrane Database Syst Rev, 2012, 11(11): CD009092.
[12]
Hwang SS, Cannom RR, Abbas MA, et al. Diverticulitis in transplant patients and patients on chronic corticosteroid therapy: a systematic review [J]. Dis Colon Rectum, 2010, 53(12): 1699-1707.
[13]
Feingold D, Steele SR, Lee S, et al. Practice parameters for the treatment of sigmoid diverticulitis [J]. Dis Colon Rectum, 2014, 57(3): 284-294.
[14]
Soni S, Sudeep T, Mohan PP, et al. Management of Hinchey II diverticulitis [J]. World J Gastroenterol, 2008, 14(47): 7163-7169.
[15]
Elagili F, Stocchi L, Ozuner G, et al. Antibiotics alone instead of percutaneous drainage as initial treatment of large diverticular abscess [J]. Tech Coloproctol, 2015, 19(2): 97-103.
[16]
Nagata N, Ishii N, Manabe N, et al. Guidelines for colonic diverticular bleeding and colonic diverticulitis: Japan gastroentero-logical association [J]. Digestion, 2019, 99(suppl 1): 1-26.
[17]
Oberkofler CE, Rickenbacher A, Raptis DA, et al. A multicenter randomized clinical trial of primary anastomosis or hartmann′s procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis [J]. Ann surg, 2012, 256(5): 819-827.
[18]
Binda GA, Karas JR, Serventi A, et al. Primary anastomosis vs. nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial [J]. Colorectal Dis, 2012, 14(11): 1403-1410.
[19]
Binda GA, Serventi A, Puntoni M, et al. Primary anastomosis versus Hartmann′s procedure for perforated diverticulitis with peritonitis: an impracticable trial [J]. Ann Surg, 2015, 261: e116-e117.
[20]
Siddiqui MR, Sajid MS, Qureshi S, et al. Elective laparoscopic sigmoid resection for diverticular disease has fewer complications than conventional surgery: a meta-analysis [J]. Am J Surg, 2010, 200(1): 144-161.
[21]
Klarenbeek BR, Veenhof AA, Bergamaschi R, et al. Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: a randomized control trial [J]. Ann Surg, 2009, 249(1): 39-44.
[22]
Gervaz P, Inan I, Perneger T, et al. A prospective, randomized, single-blind comparison of laparoscopic versus open sigmoid colectomy for diverticulitis [J]. Ann Surg, 2010, 252(1): 3-8.
[23]
Gervaz P, Mugnier-Konrad B, Morel P, et al. Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial [J]. Surg Endosc, 2011, 25(10): 3373-3378.
[24]
Carabotti M, Annibale B, Severi C, et al. Role of fibre in symptomatic uncomplicated diverticular disease: a systematic review [J]. Nutrients, 2017, 9(2): E161.
[25]
Lahner E, Bellisario C, Hassan C, et al. Probiotics in the treatment of diverticular disease: a systematic review [J]. J Gastrointestin Liver Dis, 2016, 25(1): 79-86.
[26]
Carter F, Alsayb M, Marshall JK, et al. Mesalamine (5-ASA) for the prevention of recurrent diverticulitis [J]. Cochrane Database Syst Rev, 2017, 10: CD009839.
[27]
Lanas A, Ponce J, Bignamini A, et al. One year intermittent rifaximin plus fibre supplementation vs. fibre supplementation alone to prevent diverticulitis recurrence: a proof-of-concept study [J]. Dig Liver Dis, 2013, 45(2): 104-109.
[1] 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.
[2] 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.
[3] 崔宏帅, 冯丽明, 东维玲, 韩博. 腹腔镜右半结肠癌D3根治术+IGLN清扫术治疗局部进展期结肠肝曲癌的临床效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 566-569.
[4] 丁志翔, 于鹏, 段绍斌. 血浆BRAF基因检测对腹腔镜右半结肠癌D3根治术中行幽门淋巴结清扫的指导价值[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 570-573.
[5] 王维花, 王楠, 乔庆, 罗红. 完全腹腔镜右半结肠癌切除术两种腔内消化道重建方案对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 574-577.
[6] 何慧玲, 鲁祖斌, 冯嘉莉, 梁声强. 术前外周血NLR和PLR对结肠癌术后肝转移的影响[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 682-687.
[7] 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.
[8] 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.
[9] 石阳, 于剑锋, 曹可, 翟志伟, 叶春祥, 王振军, 韩加刚. 可扩张金属支架置入联合新辅助化疗治疗完全梗阻性左半结肠癌围手术期并发症分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 464-471.
[10] 任佳琪, 刁德昌, 何自衍, 张雪阳, 唐新, 李文娟, 李洪明, 卢新泉, 易小江. 网膜融合线导向的脾曲游离技术在左半结肠癌根治术中的应用[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 362-367.
[11] 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.
[12] 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.
[13] 陈利, 杨长青, 朱风尚. 重视炎症性肠病和代谢相关脂肪性肝病间的串话机制研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 385-389.
[14] 孙文恺, 沈青, 杭丽, 张迎春. 纤维蛋白原与清蛋白比值、中性粒细胞与白蛋白比值、C反应蛋白与溃疡性结肠炎病情评估和预后的关系[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 426-431.
[15] 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.
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?