克罗恩病手术治疗后复发危险因素分析

Analysis on the risk factors of recurrence in patients with Crohn's disease after surgery

目的：探讨克罗恩病手术治疗后复发的危险因素。方法：回顾性分析78例克罗恩病患者的临床资料。所有患者均于第1次手术出院后随访12~70个月,分为未复发组33例和复发组45例。采用多分类Logistic回归分析术后复发的相关危险因素。结果：两组患者在吸烟史、疾病原发部位、疾病类型、肠内营养情况、术前1年内使用免疫抑制剂方面差异有统计学意义（P〈0.05,P〈0.01）。结论：克罗恩病病变部位为回结肠型（L3型）、疾病类型为穿透型（B3型）术前两周内肠内营养制剂提供热量〈500 kcal/d及术前1年内使用免疫抑制剂的患者术后有较高的复发再次手术风险。

Objective：To explore the risk factors of recurrence in patients with Crohn＇ s disease after surgery. Methods： The clinical data of 78 patients with Crohn＇ s disease were retrospectively analyzed. All the patients were followed up 12 to 70 months after discharge on the first surgery and were divided into non-recurrence group （n = 33 ） and recurrence group （n = 45）. The recurrence-re- lated risk factors were analyzed using multi-classification logistic regression analysis. Results ：TI0e difference was statistically significant between two sroups regarding the smoking history,disease primary sites and types,enteral nutrition status and application of immuno- suppressors within 1 year prior to surgery （P 〈 0. 05,P 〈 0. 01）. Conclusion ：The postoperative patients with Crohn＇ s disease, with il- eoeolie type （ type L3 ） lesion site, penetrating type （ type B3 ） disease type, calory of enteral nutrition preparation within 2 weeks 〈 500 kcal/d and immunosuppressors within 1 year before surgery have higher recurrence risk of reoperation.