肛周克罗恩病18例临床分析

Clinical analysis ofeighteen cases periana Crohn's disease

目的探讨肛周克罗恩病的临床特点、诊断及治疗方法。方法回顾性分析中国医科大学附属第四医院肛肠外科2012年1月至2014年12月期间收治的18例肛周克罗恩病患者的临床资料。结果所有病例均行手术治疗,术后给予抗炎、抑酸、坐浴熏洗等对症支持治疗,痊愈12例,6例中有2例在术后半年复发、4例在术后1年复发;痊愈患者术后随访1年未见复发。结论肛周克罗恩病临床表现无明显特异性,容易误诊延误病情治疗,诊断该病主要依靠细致的病史采集、临床表现、以及完善的影像学检查,治疗方法以手术治疗为主,早期诊断,早期治疗,避免误诊,是治愈肛周克罗恩病,降低复发率的重要措施。

Objective To analyze the clinical manifestation,diagnosis and treatment of the Perianal Crohn＇s disease（PCD）,and to provide clinical experiences for future diagnosis and treatment for the disease.Methods The clinical characteristics of the eighteen patients with perianal fistulas secondary to Crohn＇s disease admitted in the Fourth Affiliated Hospital of China Medical University from January 2012 to December 2014 were summarized and analyzed retrospectively.Results：All the cases received surgical treatment and postoperative anti-inflammatory,acid suppression,sitz bath fumigation and other symptomatic support treatment.Twelve cases cured,and one third cases had postoperative recurrence in half a year.Four cases recurred after operation in one year,and no recurrence was noted after surgery in one-year followed up.Conclusion The clinical manifestation of Perianal Crohn＇s disease（PCD）has no obvious specificity,therefore,it is easy to make misdiagnosis and delay disease treatment.The essence of diagnosis of the disease mainly rely on detailed collection,clinical manifestation,and imaging examination.The main treatment of PCD is surgical.Early diagnosis and treatment,avoidding misdiagnosis are the most important measure to cure the disease and reduce the recurrence rate.