暴露于先进疗法和克罗恩病手术的风险
Marc M Mankarious1, Kara Dijoseph2, Alicia C Greene1
1Department of Surgery, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Surgical endoscopy
|July 7, 2025
概括
对于克罗恩氏病患者来说,使用抗整合素治疗首先会增加与TNF-α抑制剂相比的手术风险. 多种先进疗法也会增加手术风险,但不会影响并发症.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 炎症性肠病 (IBD) 管理已经取得了进展,减少了手术切除率.
- 然而,一些克罗恩氏病 (CD) 患者仍然需要手术,尽管有多种先进疗法 (AT).
- 了解AT对手术风险的影响对于优化CD治疗至关重要.
研究的目的:
- 调查AT的数量,类型和进展与CD患者手术切除风险之间的关系.
- 评估AT和术后并发症,再入院和急诊室访问之间的关联.
主要方法:
- 使用MarketScan数据库 (2005-2020) 的回顾性队列研究.
- 包括成年CD患者在AT,评估数量,类和并发症.
- 对于手术切除风险的时间变化的考克斯回归;对于次要结果的后勤回归.
主要成果:
- 在15547名CD患者中,有10.6%接受了手术.
- 第一线抗整合素治疗显示了较高的手术风险 (HR 1.39) 与TNF-α抑制剂 (p<0.05).
- 增加AT使用 (2,3或≥4) 显著增加手术风险 (HRs2.80-7.82,p<0.001).
- AT 号/类与术后并发症,再入院或急救诊所访问无关.
结论:
- 第一线抗整合素治疗与CD中更高的手术风险有关.
- 支持TNF-α抑制剂作为治疗先的CD患者首选的一线治疗.
- 多学科护理对于识别和管理手术风险患者至关重要.
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