克罗恩病与肠结核患者出院后随访分析  

Study on the follow up of Crohn's disease and intestinal tuberculosis

作　　者：李学锋[1] 殷亚妮[1] 李富军[2] 卢放根[1] 邹益友[2] 吴小平[1] 

机构地区：[1]中南大学湘雅二医院消化科,湖南长沙410011 [2]中南大学湘雅医院消化科

出　　处：《胃肠病学和肝病学杂志》2012年第8期767-770,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨克罗恩病(Crohn’s disease,CD)和肠结核(intestinal tuberculosis,ITB)患者出院后的病情变化和预后。方法选取住院诊断为CD和ITB患者各50例,电话随访得到患者出院后进一步的诊治和疾病预后等具体资料,并进行总结分析。结果肠结核随访成功34例,平均随访(28.77±10.53)个月,最后确诊31例;CD随访成功32例,平均随访(29.56±14.90)个月,最后确诊32例。肠结核患者服药依从性好,平均服药(13.77±7.06)个月,已愈29例,复发2例。CD患者服药以5-氨基水杨酸为主,服药依从性欠佳,平均服药(15.31±11.12)个月,缓解稳定9例(28.1%),好转16例(50.0%),病情加重7例(21.9%),出院后复发23例(71.9%),出院后手术治疗3例(9.4%)。住院期间13例CD手术患者中,缓解稳定6例,好转5例,病情加重2例,短期内总体效果优于非手术治疗患者。结论肠结核预后好、复发低,应指导按疗程服药,加强随诊。CD预后不佳、复发率高,应加强出院后随访,提高服药依从性。手术治疗对部分患者短期缓解稳定有益,这可能与CD临床表型有关。Objective To study the diagnosis, treatment and prognosis of the post-discharged patients diagnosed Crohn＇ s disease and intestinal tuberculosis in clinic. Methods 50 cases of CD and 50 cases of ITB cases were select- ed. The detailed material such as the further treatment and its prognosis were obtained through telephone follow-up. Re- sults 34 ITB cases were followed up and 31 cases were definitely diagnosed. The average followed up duration was （28.77 ＋_ 10.53） months. 32 CD cases were followed up and 32 cases were definitely diagnosed. The average followed up duration was （29.56-＋ 14.90） months. ITB patients had a good drug compliance. The average drug-administration duration was （13.77 _＋7.06） months. 29 cases were cured and 2 cases relapsed. But the compliance was bad. CD pa- tients took 5-ASA mostly and drug administration compliance was poor. The average drug-administration duration was （15.31 _＋ 11.12） months. 9 cases （28.1%）were in steady remission status. 16 cases were mend （50.0%）. 7 cases were deteriorated （21.9%）. 23 cases （71.9%） were relapsed after discharged. And 3 cases （9.4%） were operated after discharged. In 13 CD surgical patients, 6 cases were in steady remission status. 5 cases were mend. 2 cases were deteriorated. The general effect was better than non-operative patients. Conclusion The prognosis of intestinal tubercu- losis was good and had a low recurrence. Patients should be instructed to take medicine course of treatment and follow up on time. The prognosis of CD was had and had a high recurrence, patients should be advised to have regular follow- up after discharged to improve drug compliance. Surgical treatment is beneficial for some patients, because it can obtain a short-time remission and stability, which may be associated with clinical phenotypes of the patients.

关 键 词：克罗恩病 肠结核 随访 预后 

分 类 号：R574.62[医药卫生—消化系统]