克罗恩病并发腹腔脓肿的临床特征与外科治疗

Clinical characteristics and surgical treatment of Crohn disease complicated with intraabdominal abscess

目的探讨克罗恩病（CD）合并腹腔脓肿的临床特征和外科治疗及预后。方法对2000-2005年间收治的142例CD患者其中合并腹腔脓肿的39例临床资料进行总结分析。结果本组CD患者合并腹腔脓肿的总发病率为27．5％，从发病到脓肿形成的时间范围为0．22年。平均5年。发病年龄（34．7±12．3）岁。24例（61．5％）患者既往有手术史；30例（76．9％）患者的脓肿发生在右侧腹，尤其是在吻合口附近（48．7％）。36例（92．3％）采取手术治疗，其中34例（34／36，94．4％）行手术引流加病变肠管切除，恢复良好。结论CD有较高的腹腔脓肿并发率，发病年龄多在35岁，将近50％发生在原吻合口；脓肿前的CD病程平均5年；手术方式以脓肿引流加病变肠管切除为主。

Objective To elucidate the clinical characteristics and surgical treatment of intraabdominal abscess in patients with Crohn disease（CD）. Methods Clinical data of 39 patients with CD complicated with intra-abdominal abscess from 2000 to 2005 were analyzed retrospectively. Results The cumulative incidence of intra-abdominal abscesses was 27.5%. Of the 39 CD patients with abscess, 61.5% had surgery the time of present study. The mean age of the patients with abscesses was （34.7± 12.3） years, and the duration of illness from the onset of CD until development of an abscess was （0- 22） years, with 5 years of the average duration. In terms of location of abscess, it occurred most often on the right side（76.9%）, especially near the site of anastomosis （48.7%）. Most patients （34 cases, 94.4%） were treated with surgical drainage and intestinal resection. Conclusions Abscess formation was noted in 27.5% of patients with CD, with nearly half of abscesses occurring near the anastomotie site. The mean age of patients with abscess was 35 years, with 5 years of the duration of illness. Most abscesses were treated with operative drainage and intestinal resection.