对于小儿周边克罗恩病而言, Ostomy 管理
William R Johnston1, Rosa Hwang2, Peter Mattei3
1General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Journal of pediatric surgery
|December 16, 2023
概括
对于小儿近门克罗恩病的便转移具有较低的逆转率,特别是在狭窄的情况下. 如果克罗恩氏病得到控制,患有裂性疾病的患者可能会成功逆转.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 炎症性肠道疾病研究研究
背景情况:
- 儿科围性克朗氏病 (CD) 常常呈现出难以治疗的囊,腹和狭窄.
- 便转移是最后的手段,但其长期的结果和儿童CD的管理尚未明确.
研究的目的:
- 为了确定预测患有围性CD的儿科患者骨髓逆转的因素.
- 制定管理建议,对周CD.Fistulizing和狭窄.
主要方法:
- 在2011年至2021年期间,对患有CD的儿科患者 (1-18岁) 进行了围外科手术的回顾性评估.
- 医学治疗,麻醉下检查 (EUA),疾病反应和便转移/逆转率的分析.
主要成果:
- 在109名患有抽性CD和21名患有狭窄性CD的患者中,分别有7%和19%接受了转移.
- 只有3名患有裂性疾病的患者在实现CD控制后成功逆转了骨;一名患有狭窄的患者逆转了,但需要持续扩张.
- 大多数患者仍然长期转移,需要重复的EUA,而患有狭窄症的患者则面临进展或永久性骨髓损伤.
结论:
- 儿科围性CD中 Ostomy 的逆转率很低,并且转移并不能消除对未来干预的需求,如EUAs.
- 成功逆转更有可能发生在医疗反应良好的曲性CD病例中.
- 患有狭窄性CD的患者更容易出现逆转失败,可能需要终身部扩张或永久性口腔.
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