复杂克罗恩病的临床特征

Clinical characteristics of complicated Crohn's disease

目的:总结分析复杂克罗恩病(CD)的临床特征和外科治疗的预后。方法:对2000年至2005年收治的142例CD病人中,发生各种并发症的128例复杂CD病人的资料进行回顾性分析。结果:本组CD病人发生的并发症主要有肠瘘、腹腔脓肿、肠梗阻、肠穿孔、消化道大出血等,其累计发生率为90.1%。既往有无手术史对复杂CD并发症的累计发生率并无显著影响。从患病至并发症形成的平均时间为(5.7±5.5)年,而患病年龄为(30.7±13.1)岁。本组98例(76.6%)病人行手术治疗,共死亡7例,治愈与好转率达94.53%,病死率为5.47%。结论:CD有较高的并发症累计发生率,并发症前的病程多为5年,手术对复杂CD的远期病程无显著改善。

Objective： To elucidate the clinical characteristics of the patients with complicated Crohn＇s disease （CD）. Methods： Clinical data of 128 complicated CD with complications out of the 142 CD patients from 2000 to 2005 were analyzed. Results： The cumulative incidence of severe complications was 90.1% after CD onset, which included enterocutaneous fistula, abdominal abscess, bowel obstruction, perforation, and massive digestive bleeding. There was no difference in the cumulative rate of having complications between operated and non-operated patients. The age when CD developed was （30.7 ± 13.1 ） years, and the duration of illness from the onset of CD to development of complications was （5.7 ±5.5 ） years. 98 patients （76.6%） were treated with surgery. Conclusion： Complication formation was noted in about 90.1% of patients with CD with 5.7 years of the duration of illness. The operation has no obvious improvement on the cumulative incidence of severe complications with complicated CD patients.