锡格分炎:一个系统的审查
Arden M Morris1, Scott E Regenbogen1, Karin M Hardiman1
1Division of Colorectal Surgery, Department of Surgery, University of Michigan, Ann Arbor.
JAMA
|January 17, 2014
概括
皮炎往往具有良性自然史,复发风险比以前认为的更低. 对于慢性或复发的病例,可能不需要积极的抗生素或手术治疗.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 内部医学 内部医学
背景情况:
- 椎炎是一种普遍的胃肠道疾病.
- 了解其自然历史和病理生理学对于有效管理至关重要.
- 基于新的证据,治疗模式正在发展.
研究的目的:
- 审查目前对分泌炎病因和自然史的理解.
- 分析最近变化的治疗指导方针对于膜炎.
- 评估医学和外科干预的证据.
主要方法:
- 对MEDLINE和Cochrane数据库 (2000-2013年) 的系统审查.
- 包括有关诊断和管理的英语文章.
- 排除小案例系列和2000年之前的数据;证据的分级.
主要成果:
- 病理生理学涉及改变肠道运动性,增加压力和微环境变化.
- 无并发性分泌体炎通常遵循一种良性自然史,复发率低.
- 抗生素和纤维显示的益处有限;梅萨拉可能有用;手术并不总是适用的.
结论:
- 目前的证据表明,积极的抗生素或手术干预的作用减少了.
- 慢性或复发性垂炎的治疗应该是个性化的.
- 进一步的研究可能会根据患者的结果来改进治疗策略.
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