克罗恩病的外科诊治

Surgical diagnosis and treatment of Crohn disease

目的探讨克罗恩病的临床表现、手术适应证和手术方法。方法收集2000～2007年两家医院外科手术治疗12例克罗恩病患者的临床资料。结果12例患者入院时临床表现为肠梗阻、消化道出血、弥漫性腹膜炎、胃肠穿孔或肠瘘。术前诊断仅3例,误诊率极高。全组均经手术治疗,行肠切除术、肠造瘘术、腹腔引流术。术后复发2例,再手术1例。结论克罗恩病为慢性非特异性肠道疾病,临床表现多种多样,手术是治疗克罗恩病并发症的主要手段,术后预防复发很重要。

Objective To explore the clinical manifestation,surgical indication,and modus operandi of Crohn disease. Methods The clinical data of 12 patients with Crohn disease was collected and analyzed who underwent surgical operations from 2000 to 2007. Results The clinical manifestations on admission of the 12 cases were intestinal obstruction, alimentary tract hemorrhage, diffuse peritonitis, gastric-intestinal perforation, or intestinal fistula. Only 3 cases were correctly diagnosed before operations, and the misdiagnosis ra;e was very high. All cases underwent operations （enterectomy,enterostomy,or peritoneal drainage）. 2 cases were recurrent after operation,and 1 case was experienced reoperation. Conclusion Crohn disease is a chronic non-specific inflammation disease of the intestine. Its clinical manifestation is variable. Operation is a main mean for treatment of its complications. It is very important to prevent postoperative recurrence of Crohn disease.