炎性肠病手术时机的选择

Timing of surgery in inflammatory bowel disease

炎性肠病虽然是以内科治疗为主的疾病．但外科处理是不可缺少的治疗手段。对于有手术适应证的患者．应及时进行外科治疗。回避外科治疗，企网采用药物治疗代替手术不但达不到治疗效果．而且由于拖延了治疗时机，显著增加手术风险。迄今已明确。无效的内科治疗、使用糖皮质激素、营养不良和合并感染均是手术的危险因素，急诊手术和活动期手术也增加手术风险。内科医生应该准确把握手术时机，为具有手术指征的患者创造手术条件。

Surgery is an integral part in the treatment of inflammatory bowel disease. Timely surgery is very necessary, and can reduce the risk of postoperative complications. Overemphasizing the importance of medical therapy and prolonged use attempting to evade surgery can not maximize the efficacy of medical treatment, but may miss the optimal chance of surgical treatment. It has already been confirmed that ineffective medical treatment, corticosteroid use, malnutrition and infection are the risk factors of surgical complications and should be avoided. Emergency operation and operation at active stage of IBD also increase the surgical risk. Gastroenterologists should be responsible for the judgment of surgery timing and create surgical conditions for the patients with surgical indications.