在炎症性肠病中临床决策模仿:从炎症性肠病实践管理 LIVE
Hannah W Fiske1, Christopher Ward2, Samir A Shah3
1Department of Internal Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Crohn's & colitis 360
|May 9, 2024
概括
在IBD LIVE中讨论的很大一部分病例不是炎症性肠病 (IBD),而是模仿性肠病,这凸显了需要仔细差异诊断的需要. 错误诊断可能导致不适当的治疗和不良事件,影响患者护理质量和成本.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- IBD LIVE是一个每周的视频会议,讨论具有挑战性的炎症性肠病 (IBD) 病例.
- 显著的数量呈现的病例被确定为IBD模仿,不确认IBD.
- 这项研究对IBD模仿物进行了分类,并分析了它们对临床管理的影响.
研究的目的:
- 在IBD LIVE中呈现的病例进行分类,区分确诊的IBD和IBD模仿者.
- 为了分析IBD的诊断和治疗工作,模仿IBD.
- 了解错误诊断IBD的临床管理影响.
主要方法:
- 审查了从2018年5月到2023年2月在IBD LIVE上存档的371起案件.
- 将病例分类为确诊的IBD和IBD模仿者.
- 对IBD模仿的诊断评估和治疗方法的分析.
主要成果:
- 82.5%的病例被确认为IBD (克罗恩病,性结肠炎,IBD-未分类).
- 17.5%的病例 (65/371) 是IBD模仿者,最常见的是药物诱导或血管炎.
- 诊断评估包括活检,手术病理学,基因检测和成像;38%的模仿患者接受了生物药物,其中5人经历了不良事件.
结论:
- IBD和IBD模仿的各种表现需要持续考虑差异诊断.
- 对于被认为IBD患者没有临床反应,对治疗的重新评估至关重要.
- 准确的IBD诊断与模仿对适当,经济有效的患者护理至关重要.
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