目的观察处于活动期与缓解期的克罗恩病(CD)患者术后并发症及复发的情况,并加以比较。方法回顾性分析2002年1月至2011年1月因CD相关并发症在南京军区南京总医院行肠切除吻合手术的90例患者的临床资料,比较缓解期CD(47例)与活动期CD(43例)患者术后内镜复发、临床复发、并发症发生率、拆线时间、术后住院天数及住院花费情况。结果2组患者术后并发症发生率(分别为14.9%和51.2%,X2=6.979)、拆线时间(t=4.124)、术后住院时间(t=8.837)差异比较均有统计学意义(P〈0.001)。2组术后1年累计内镜下复发率分别为8.5%和27.9%,差异有统计学意义(X2=4.605,P=0.032),术后2、3年的复发率比较差异无统计学意义。结论缓解期CD患者术后并发症发生率低,伤口愈合快,住院天数短,住院花费少,且术后早期内镜下复发率低;但疾病处于活动期与缓解期CD患者在术后远期复发率方面没有差异。
Objective To determine whether the perioperative disease activity is associated with recurrence and complications after bowel resection for Crohn's disease (CD). Methods Clinical data of patients underwent bowel resection for CD at the Nanjing General Hospital of Nanjing Military Command from January 2002 to January 2011 was retrospectively analyzed. Postoperative recurrence and complications in patients with active disease were compared with those in patients with remission. Results A total of 90 patients underwent bowel resection for CD, active disease were seen in 43 patients at the time of surgery, while the rest 47 patients were in remission. The postoperative cumulative endoscopic recurrence rate was 8.5% at 1 year, 27.7% at 2 years and 44.7% at 3 years in the patients with remission, and was 27.9% at 1 year, 37.2% at 2 years and 53.5% at 3 years in patients with active disease. Data indicated the endoscopic recurrence were statistically significant in the first year after surgery ( X2 = 4. 605, P = 0. 032 ). Additional, the postoperative complication rates in patients with remission (14. 9% ) was significantly lower than that in patients with active disease (51.2% ) ( ~2 = 6. 979, P 〈 0. 001 ). Conclusion Patients with active disease at the time of surgery were encountered with early postoperative recurrence and increased complications after intestinal resection for CD.