克罗恩病的肠外表现和并发症

Extra-intestinal manifestations and complications of Crohn's disease

目的分析克罗恩病(CD)伴随的肠外表现和并发症,观察病变部位与临床类型之间的关系。方法采用x2 检验对40例CD患者进行回顾性分析。结果16例(40 0%)有肠外表现,其中6例(15 0%)有一种以上肠外表现。从大肠、小肠到大小肠同时受累组中,各种肠外表现的发生有增加趋势。有肠外表现各组中,有并发症及手术史者几乎均较无肠外表现组高。并发症的发生率为65 0%, 依次为肠梗阻40 0%, 肠瘘25 0%, 腹腔脓肿15 0%, 下消化道大出血12 5%, 肠穿孔10 0%, 肛周疾病5 0%, 肠癌2 5%。多数肠外表现和并发症与疾病活动性相关,肠外表现经氨基水杨酸类和(或)皮质类固醇治疗后多消失,而并发症常需手术治疗。结论CD肠外表现与并发症发生率较高,多数与疾病活动性相关,并与病变部位、临床类型等有关。

Objective:To observe the relationship between location and clinical type of Crohn's disease(CO)by analyzing its extra-inˉtestinal manifestations and complications.Methods:Forty patients with CD from1987to2004treated in our hospital were reviewed retrospectiveˉly.Results:Sixteen patients(40.0%)had extra-intestinal manifestations,6(15.0%)of these patients had more than one extra-colonic organ involvements.There was a trend of increase in the occurrence of various extra-intestinal manifestations fromthe large intestine,the small intestine to the extensiv involvements of large or small intestine at the same time.The incidence of complication and operative history in these CD patients with extra-intestinal manifestatin were greater than that in those without extra-intestinal manifestation.The incidence of complication was65.0%,which in turn,included intestinal obstruction(40.0%),intestinal fistula(25.0%),abdominal abscess(15.0%),hemorrhage of lower digestive tract(12.5%),intestinal perforation(10.0%),perianus disease(5.0%)and intestinal cancer(2.5%).Most of the extra-intestinal manifestations and complications were associated with the disease activity.The extra-intestinal manifestions could the healed with sulfasalazine and/or steroid treatment,but the complications usually needed to be operated.Conclusion:Extra-intestinal manifestations and complications commonly occurred in the patients with CD,the majority of themwere associated with the disease activity,and closely related with the location and clinical type of CD.