克罗恩病外科围手术期优化策略  

Perioperative optimization for Crohn's disease surgery

作　　者：郭坤[1] 王革非[1] 吴秀文[1] GUO Kun reviewing;WANG Ge-fei;WU Xiu-wen checking(Medical School of Nanjing University, Department of General Surgery, Nanjing Jinling Hospital, Nanjing 210002, Jiangsu, China)

机构地区：[1]南京大学医学院临床学院南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2018年第3期180-183,共4页Parenteral & Enteral Nutrition

基　　金：江苏省重点研发计划社会发展项目(BE2016752)(BE2017722)

摘　　要：克罗恩病是一种慢性特发性肠道炎性疾病,病变可累及全消化道。主要的并发症包括形成狭窄、瘘管、脓肿等。这些复杂的并发症对临床医师提出了巨大挑战。尽管在过去的几十年中克罗恩病的治疗取得了重大进展,但很大比例的患者最终仍须手术,至少1/3的患者须多次手术。克罗恩病的外科治疗侧重于消除疾病症状、解决并发症和恢复胃肠道的连续性。在术前,患者可能经历过长期的病程、反复的治疗失败、营养不良、药物的副反应等。克罗恩病手术的术后并发症高于其他腹部手术。因此,旨在减少术后并发症,避免将来复发和维持手术后缓解的围手术期优化策略尤其重要。Crohn＇s disease（CD） is a chronic idiopathic inflammatory bowel disease that can affect any part of the gastrointestinal tract. Major complications include formation of strictures, fistulas or abscesses. These complicating factors of CD pose significant challenges to the clinician. Despite significant advances in therapy over the past decades, a significant proportion of the patients will eventually require surgery, with at least one third of patients requiring multiple surgeries. The surgical treatment of CD focuses on the elimination of disease symptoms while solving the complications and maintaining intestinal continuity. Before surgery, patients may have experienced long-term course of disease, repeated treatment failure, malnutrition and side effects of medicine. Postoperative complications are seen more frequently in patients requiring abdominal surgery for CD than in patients requiring abdominal surgery for other conditions. Therefore, perioperative optimization strategy is critical to reduce the postoperative complications, to avoid future recurrence and to maintain surgery induced remission.

关 键 词：克罗恩病 围手术期 优化 

分 类 号：R656.7[医药卫生—外科学]