在克罗恩氏病中术后复发的内镜评分有多可靠? :一个系统审查和元分析
Eline M L van der Does de Willebois1, Vittoria Bellato2, Marjolijn Duijvestein3
1From the Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands.
概括
对于克罗恩病的内眼切除术后,内镜复发率差异很大,从5%到93%. 这种显著的变化凸显了改善内镜评分的必要性,以准确诊断复发并管理患者的生活质量.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床医学 临床医学
背景情况:
- 对于克罗恩氏病 (CD) 的内镜切除 (ICR) 后,建议进行内镜监测,以检测复发.
- 目前的内镜评分系统,如鲁特格尔茨评分 (RS) 和修改的鲁特格尔茨评分 (mRS),用于评估复发.
研究的目的:
- 为了评估内镜复发 (ER) 率的变化,在CD的ICR之后进行CD.
- 为了评估ER率的范围,使用鲁特吉茨得分 (RS) 和修改的鲁特吉茨得分 (mRS) 分类.
主要方法:
- 在MEDLINE,Embase和Cochrane图书馆进行了系统的文献搜索.
- 包括随机对照试验和队列研究报告ER在CD的ICR后12个月内.
- 对76项涉及7751名患者的研究数据进行了比例元分析.
主要成果:
- 在所有研究中,ER率的加权平均值为44.0%,整体范围为5.0%至93.0%.
- 对于RS和mRS的加权平均ER率分别为44.0%和41.1%.
- 观察到显著的变化,RS在5.0%至93.0%之间,mRS在19.8%至62.9%之间.
结论:
- 在CD的ICR后,ER率的实质性变化被证明.
- 这种变化表明疾病复发的潜在诊断不足,影响患者的生活质量和医疗保健成本.
- 对于复发性CD而言,急需加强内镜评分方法.
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