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Mucosal healing and deep remission: What does it mean? 被引量:4
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作者 Gerhard Rogler Stephan Vavricka +1 位作者 Alain Schoepfer Peter L Lakatos 《World Journal of Gastroenterology》 SCIE CAS 2013年第43期7552-7560,共9页
The use of specific terms under different meanings and varying definitions has always been a source of confusion in science.When we point our efforts towards an evidence based medicine for inflammatory bowel diseases(... The use of specific terms under different meanings and varying definitions has always been a source of confusion in science.When we point our efforts towards an evidence based medicine for inflammatory bowel diseases(IBD)the same is true:Terms such as"mucosal healing"or"deep remission"as endpoints in clinical trials or treatment goals in daily patient care may contribute to misconceptions if meanings change over time or definitions are altered.It appears to be useful to first have a look at the development of terms and their definitions,to assess their intrinsic and context-independent problems and then to analyze the different relevance in present-day clinical studies and trials.The purpose of such an attempt would be to gain clearer insights into the true impact of the clinical findings behind the terms.It may also lead to a better defined use of those terms for future studies.The terms"mucosal healing"and"deep remission"have been introduced in recent years as new therapeutic targets in the treatment of IBD patients.Several clinical trials,cohort studies or inception cohorts provided data that the long term disease course is better,when mucosal healing is achieved.However,it is still unclear whether continued or increased therapeutic measures will aid or improve mucosal healing for patients in clinical remission.Clinical trials are under way to answer this question.Attention should be paid to clearly address what levels of IBD activity are looked at.In the present review article authors aim to summarize the current evidence available on mucosal healing and deep remission and try to highlight their value and position in the everyday decision making for gastroenterologists. 展开更多
关键词 INFLAMMATORY BOWEL disease mucosal HEALING deep REMISSION Treatment targets Clinical activity
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Mucosal healing in inflammatory bowel disease: Maintain orde-escalate therapy 被引量:6
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作者 Marcello Cintolo Giuseppe Costantino +1 位作者 Socrate Pallio Walter Fries 《World Journal of Gastrointestinal Pathophysiology》 CAS 2016年第1期1-16,共16页
In the past decade, thanks to the introduction of biologic therapies, a new therapeutic goal, mucosal healing(MH), has been introduced. MH is the expression of an arrest of disease progression, resulting in minor hosp... In the past decade, thanks to the introduction of biologic therapies, a new therapeutic goal, mucosal healing(MH), has been introduced. MH is the expression of an arrest of disease progression, resulting in minor hospitalizations, surgeries, and prolonged clinical remission. MH may be achieved with several therapeutic strategies reaching success rates up to 80% for both, ulcerative colitis(UC) and Crohn's disease(CD). Various scoring systems for UC and for the transmural CD, have been proposed to standardize the definition of MH. Several attempts have been undertaken to de-escalate therapy once MH is achieved, thus, reducing the risk of adverse events. In this review, we analysed the available studies regarding the achievement of MH and the subsequent treatment de-escalation according to disease type and administered therapy, together with non-invasive markers proposed as predictors for relapse. The available data are not encouraging since de-escalation after the achievement of MH is followed by a high number of clinical relapses reaching up to 50% within one year. Unclear is also another question, in case of combination therapies, which drug is more appropriate to stop, in order to guarantee a durable remission. Predictors of unfavourable outcome such as disease extension, perianal disease, or early onset disease appear to be inadequate to foresee behaviour of disease. Further studies are warranted to investigate the role of histologic healing for the further course of disease. 展开更多
关键词 DE-ESCALATION mucosal healing Biologicaltherapy deep REMISSION DISCONTINUATION Ulcerativecolitis Crohn's disease Immunosuppressors
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Silver nitrate mimicking a foreign body in the pharyngeal mucosal space
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作者 Devon Livingstone Yazeed Alghonaim +3 位作者 Nathan Jowett Eyal Sela Alex Mlynarek Reza Forghani 《World Journal of Radiology》 CAS 2015年第5期100-103,共4页
Silver nitrate is sometimes used as a means of chemicalcauterization for control of minor bleeding and management of hypergranulation tissue following bedside head and neck procedures. There are only few reports avail... Silver nitrate is sometimes used as a means of chemicalcauterization for control of minor bleeding and management of hypergranulation tissue following bedside head and neck procedures. There are only few reports available on the imaging appearance of silver nitrate and its potential to mimic a foreign body. We report a case of a patient presenting with dysphagia, odynophagia, and fever following dental work who had a peritonsillar incision and drainage for treatment of a deep neck space infection. During the procedure, silver nitrate was applied to halt the bleeding. Patient was subsequently transferred to another institution. Since the patient was not showing significant clinical improvement on antibiotic therapy, a computed tomography(CT) scan was performed demonstrating a hyperdense structure lodged in the pharyngeal mucosal space in the oropharynx and soft palate that was mistaken for a foreign body such as bone. Silver nitrate can have density similar to bone but does not have the normal architecture of bone with cortex and marrow on CT. Familiarity with the appearance of silver nitrate on CT, lack of bone architecture, and proper documentation and communication of the use of silver nitrate to the consultant radiologist and medical personnel could help avoid misdiagnosis and potentially unnecessary surgical exploration. 展开更多
关键词 Silver nitrate Computed tomography BONY foreign body Soft tissues NECK deep NECK INFECTIONS PHARYNGEAL mucosal SPACE
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炎症性肠病治疗的理想目标:深度缓解的意义和对策 被引量:4
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作者 王承党 郭晓雄 《世界华人消化杂志》 CAS 2015年第24期3824-3830,共7页
炎症性肠病(inflammatory bowel disease,I B D)是一种慢性非特异性肠道炎症性疾病,其病因不明确,可能是遗传因素、环境因素、免疫反应异常等多因素共同作用的结果.目前传统治疗药物有氨基水杨酸制剂、糖皮质激素、免疫抑制剂等,及生物... 炎症性肠病(inflammatory bowel disease,I B D)是一种慢性非特异性肠道炎症性疾病,其病因不明确,可能是遗传因素、环境因素、免疫反应异常等多因素共同作用的结果.目前传统治疗药物有氨基水杨酸制剂、糖皮质激素、免疫抑制剂等,及生物制剂如抗肿瘤坏死因子-?.现阶段治疗多数以改善症状和达到临床缓解为治疗终点,随着对治疗后的预后的观察研究,发现仅仅达到临床缓解,并不能完全改变IBD的整体预后,仍易发生各种并发症,严重影响生活质量,甚至危及生命,同时也不断增加患者经济负担.因此,我们的治疗目标终点已经从临床症状改善和临床缓解(clinical response and remission)提升到黏膜愈合(mucosal healing),再到追求深度缓解(deep remission).本文就深度缓解的概念、意义及对策进行阐述. 展开更多
关键词 炎症性肠病 临床缓解 黏膜愈合 深度缓解 组织学炎症 黏膜低度炎症
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婴幼儿唇部血管瘤的临床分型和治疗探讨 被引量:1
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作者 陈深 李思敏 +3 位作者 陈伯红 吕顽 莫鸿忠 林诚 《实用口腔医学杂志》 CSCD 北大核心 2017年第6期847-849,共3页
根据血管瘤分型原则、结合唇部的特殊组织结构将婴幼儿唇部血管瘤分为7型:唇部皮肤浅表型血管瘤、唇部皮肤复合型血管瘤、唇部皮肤深在型血管瘤、唇部黏膜浅表型血管瘤、唇部黏膜复合型血管瘤、唇部黏膜深型血管瘤、唇部全层型血管瘤;... 根据血管瘤分型原则、结合唇部的特殊组织结构将婴幼儿唇部血管瘤分为7型:唇部皮肤浅表型血管瘤、唇部皮肤复合型血管瘤、唇部皮肤深在型血管瘤、唇部黏膜浅表型血管瘤、唇部黏膜复合型血管瘤、唇部黏膜深型血管瘤、唇部全层型血管瘤;唇部的特殊结构和功能导致血管瘤生长的独特性和分型的特殊性。在合理选择适应证的前提下,应用长脉冲激光联合优化脉冲光治疗唇部血管瘤可获得理想效果。 展开更多
关键词 长脉冲激光 黏膜浅表型血管瘤 黏膜复合型血管瘤 黏膜深在型血管瘤 唇部全层型血管瘤
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克罗恩病治疗的新目标:深度缓解 被引量:2
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作者 朱秀丽 王巧民 《胃肠病学和肝病学杂志》 CAS 2016年第10期1094-1097,共4页
炎症性肠病(inflammatory bowel disease,IBD)是消化系统常见疾病,包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn’s disease,CD),其发病机制未明,可能与环境、遗传、感染、免疫等多方面因素有关。其中CD多见于青年人,可侵... 炎症性肠病(inflammatory bowel disease,IBD)是消化系统常见疾病,包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn’s disease,CD),其发病机制未明,可能与环境、遗传、感染、免疫等多方面因素有关。其中CD多见于青年人,可侵及全胃肠道的任何部位,包括口腔、肛门,病变呈节段性或跳跃性分布,并可侵及肠道以外,特别是皮肤、关节。迄今尚无根治办法,现治疗上以药物治疗为主,包括5-ASA、激素、免疫抑制剂、生物制剂等,若出现肠腔狭窄、梗阻、瘘管等并发症时,可能需要手术治疗。CD的治疗目标最初为临床缓解,后主张达到黏膜愈合,近年来深度缓解作为一个新的治疗目标被提出,在国外已被广泛接受并应用于疾病评估,本文主要介绍CD深度缓解的概念、意义,并分析现临床上常用的药物治疗能否达到深度缓解。 展开更多
关键词 炎症性肠病 克罗恩病 黏膜愈合 深度缓解
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COPD患者采用间断负压经鼻气道深部吸痰研究 被引量:2
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作者 邓敏 《护理学杂志》 2012年第17期31-33,共3页
目的探讨COPD患者实施间断负压气道深部吸痰的效果。方法将100例诊断为COPD并具备吸痰指征的患者,单号为对照组(50例),按常规气道内吸引法吸痰;双号为观察组(50例),采用间断开放负压吸痰,即呼气时开放负压吸痰,吸气时堵住吸痰管侧边孔... 目的探讨COPD患者实施间断负压气道深部吸痰的效果。方法将100例诊断为COPD并具备吸痰指征的患者,单号为对照组(50例),按常规气道内吸引法吸痰;双号为观察组(50例),采用间断开放负压吸痰,即呼气时开放负压吸痰,吸气时堵住吸痰管侧边孔关闭负压。结果与对照组比较,观察组患者插管次数、吸痰次数减少,2次吸痰间隔延长,痰量增加,血氧饱和度较稳定且呼吸道黏膜损伤及低氧血症发生率显著降低(P<0.05,P<0.01)。结论COPD患者采用间断负压经鼻下气道深部吸痰能降低反复插管对患者的刺激,减少吸痰并发症的发生率。 展开更多
关键词 慢性阻塞性肺疾病 深部吸痰 间断负压 黏膜损伤 低氧血症
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Endoscopic and surgical resection of T1a/T1b esophageal neoplasms: A systematic review 被引量:44
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作者 George Sgourakis Ines Gockel Hauke Lang 《World Journal of Gastroenterology》 SCIE CAS 2013年第9期1424-1437,共14页
AIM: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/ T1b esophageal neoplasms. METHODS: A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane... AIM: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/ T1b esophageal neoplasms. METHODS: A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane Library, from 1997 up to January 2011 was performed. An analysis was carried out, pooling the effects of outcomes of 4241 patients enrolled in 80 retrospective studies. For comparisons across studies, each reporting on only one endoscopic method, we used a random effects meta-regression of the log-odds of the outcome of treatment in each study. "Neural networks" as a data mining technique was employed in order to establish a prediction model of lymph node status in superficial submucosal esophageal carcinoma. Another data mining technique, the "feature selection and root cause analysis", was used to identify the most impor-tant predictors of local recurrence and metachronous cancer development in endoscopically resected patients, and lymph node positivity in squamous carcinoma (SCC) and adenocarcinoma (ADC) separately in surgically resected patients. RESULTS: Endoscopically resected patients: Low grade dysplasia was observed in 4% of patients, high grade dysplasia in 14.6%, carcinoma in situ in 19%, mucosal cancer in 54%, and submucosal cancer in 16% of patients. There were no significant differences between endoscopic mucosal resection and endoscopic submucosal dissection (ESD) for the following parameters: complications, patients submitted to surgery, positive margins, lymph node positivity, local recurrence and metachronous cancer. With regard to piecemeal resection, ESD performed better since the number of cases was significantly less [coefficient: -7.709438, 95%CI: (-11.03803, -4.380844), P < 0.001]; hence local recurrence rates were significantly lower [coefficient: -4.033528, 95%CI: (-6.151498, -1.915559),P < 0.01]. A higher rate of esophageal stenosis was observed following ESD [coefficient: 7.322266, 95%CI: (3.810146, 10.83439), P < 0.001]. A significantly greater number of SCC patients were submitted to surgery (log-odds, ADC: -2.1206 ± 0.6249 vs SCC: 4.1356 ± 0.4038, P < 0.05). The odds for re-classification of tumor stage after endoscopic resection were 53% and 39% for ADC and SCC, respectively. Local tumor recurrence was best predicted by grade 3 differentiation and piecemeal resection, metachronous cancer development by the carcinoma in situ component, and lymph node positivity by lymphovascular invasion. With regard to surgically resected patients: Significant differences in patients with positive lymph nodes were observed between ADC and SCC [coefficient: 1.889569, 95%CI: (0.3945146, 3.384624), P<0.01). In contrast, lymphovascular and microvascular invasion and grade 3 patients between histologic types were comparable, the respective rank order of the predictors of lymph node positivity was: Grade 3, lymphovascular invasion (L+), microvascular invasion (V+), submucosal (Sm) 3 invasion, Sm2 invasion and Sm1 invasion. Histologic type (ADC/SCC) was not included in the model. The best predictors for SCC lymph node positivity were Sm3 invasion and (V+). For ADC, the most important predictor was (L+). CONCLUSION: Local tumor recurrence is predicted by grade 3, metachronous cancer by the carcinoma insitu component, and lymph node positivity by L+. T1b cancer should be treated with surgical resection. 展开更多
关键词 SUPERFICIAL ESOPHAGEAL cancer ENDOSCOPIC resection mucosal infiltration SUBmucosal involvement Recurrent tumor Controversies in treatment Squamous cell carcinoma Adenocarcinoma Lymphatic invasion Vascular invasion SUBmucosal LAYER SUPERFICIAL SUBmucosal LAYER Middle third SUBmucosal LAYER deep third SUBmucosal LAYER ESOPHAGEAL cancer ENDOSCOPIC GASTROINTESTINAL surgical procedures ENDOSCOPIC GASTROINTESTINAL surgery Lymph node dissection Dysplasia
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Evaluation of “top-down” treatment of early Crohn's disease by double balloon enteroscopy 被引量:3
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作者 Rong Fan Jie Zhong +3 位作者 Zheng-Ting Wang Shu-Yi Li Jie Zhou Yong-Hua Tang 《World Journal of Gastroenterology》 SCIE CAS 2014年第39期14479-14487,共9页
AIM: To assess &#x0201c;top-down&#x0201d; treatment for deep remission of early moderate to severe Crohn&#x02019;s disease (CD) by double balloon enteroscopy.
关键词 Crohn’ s disease Top-down treatment deep remission Double balloon enteroscopy mucosal healing
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1例回肠造口术后粪水性皮炎并皮肤黏膜分离患者的护理 被引量:1
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作者 蒋满凤 张四芳 《消化肿瘤杂志(电子版)》 2022年第4期467-470,共4页
总结1例回肠造口术后粪水性皮炎并皮肤黏膜分离患者的护理经验。护理要点:通过对1例回肠造口黏膜分离伴粪水性皮炎患者的护理,应用两件式凸面底盘及肠造口产品附件有效收集粪水,避免了污染伤口,使伤口顺利愈合,保护皮肤,减轻患者疼痛,... 总结1例回肠造口术后粪水性皮炎并皮肤黏膜分离患者的护理经验。护理要点:通过对1例回肠造口黏膜分离伴粪水性皮炎患者的护理,应用两件式凸面底盘及肠造口产品附件有效收集粪水,避免了污染伤口,使伤口顺利愈合,保护皮肤,减轻患者疼痛,并纠正了造口黏膜分离的情况,有效的健康宣教,取得满意的护理效果。及时有效的护理可预防并治疗造口周围皮肤粪水性皮炎,提高患者的生活质量。 展开更多
关键词 回肠造口 粪水性皮炎 造口黏膜分离 凸面底盘 护理
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抗肿瘤坏死因子α治疗克罗恩病达深度缓解的临床预测因素 被引量:10
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作者 李玥 舒慧君 +4 位作者 吕红 谭蓓 李骥 杨红 钱家鸣 《中华消化杂志》 CAS CSCD 北大核心 2016年第7期461-465,共5页
目的分析英夫利西单克隆抗体(IFX)诱导 CD 患者黏膜深度缓解的临床预测因素。方法回顾性分析44例2008年2月至2015年2月接受 IFX 治疗且维持临床缓解超过6个月的 CD 患者的临床、实验室和随访资料。黏膜愈合定义为内镜检查未发现任何... 目的分析英夫利西单克隆抗体(IFX)诱导 CD 患者黏膜深度缓解的临床预测因素。方法回顾性分析44例2008年2月至2015年2月接受 IFX 治疗且维持临床缓解超过6个月的 CD 患者的临床、实验室和随访资料。黏膜愈合定义为内镜检查未发现任何溃疡;深度缓解定义为临床缓解并黏膜愈合。根据内镜随访结果将入组患者分为深度缓解组和未深度缓解组,组间计量资料的比较采用t 检验或 Wilcoxon 秩和检验,率的比较采用卡方检验。采用 Logistic 回归进行多因素分析。结果44例患者中位年龄为19.5岁,其中男39例(88.6%),女5例(11.4%),中位病程为35.0(18.5,73.5)月。有20例CD 患者在长期随访[中位随访时间19(12,29)月]达到深度缓解,实现深度缓解的平均时间为(28.9±14.3)周。20例深度缓解患者和24例未深度缓解患者的发病年龄、病程、吸烟状态、蒙特利尔临床分型、伴同药物治疗(美沙拉秦、糖皮质激素或硫唑嘌呤)、治疗前 BMI、治疗前实验室检查结果[ESR、超敏 C 反应蛋白(hsCRP)、血红蛋白、PLT 计数]均差异无统计学意义(P 均>0.05)。多因素分析显示,肠外表现(关节痛)[OR=29.9,95% CI 1.26~714.20,P =0.036]、诱导缓解治疗后(第14周)hsCRP正常(OR=0.88,95%CI 0.78~0.99,P =0.045)和 PLT 计数下降(OR =0.98,95%CI 0.96~0.99, P =0.016)是深度缓解的独立预测因素。结论 IFX 可有效治疗 CD 并维持长期深度缓解。肠外关节痛症状、诱导缓解后第14周 hsCRP 和 PLT 计数下降是深度缓解的预测因素。 展开更多
关键词 克罗恩病 英夫利西 黏膜愈合 深度缓解
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英夫利西单克隆抗体诱导和维持26例中重度克罗恩病患者深度缓解的疗效分析 被引量:5
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作者 王新颖 陈昭 +4 位作者 王国振 向城 邱琛 周洁琼 姜泊 《中华消化杂志》 CAS CSCD 北大核心 2014年第12期811-816,共6页
目的 探讨英夫利西单克隆抗体(IFX)对诱导和维持中重度CD患者深度缓解的疗效和安全性.方法 回顾性分析2012年2月至2014年4月接受IFX治疗的26例中重度CD患者的临床资料.观察治疗前,治疗后第14、30周时患者实验室指标(ESR、CRP、白蛋... 目的 探讨英夫利西单克隆抗体(IFX)对诱导和维持中重度CD患者深度缓解的疗效和安全性.方法 回顾性分析2012年2月至2014年4月接受IFX治疗的26例中重度CD患者的临床资料.观察治疗前,治疗后第14、30周时患者实验室指标(ESR、CRP、白蛋白)、克罗恩病活动度指数(CDAI)、克罗恩病简化内镜评分(SES-CD)、深度缓解率及不良反应的情况.正态分布计量资料的两组间比较采用t检验,非正态分布计量资料的两组间比较采用Wilcoxon符号秩检验,率的比较使用卡方检验或Fisher确切概率法.结果 26例CD患者中,与治疗前相比,治疗后第14周时患者CDAI评分明显下降[225.0(124.0,265.0)分比80.0(67.0,124.7)分,Z=-4.265,P<0.01]; ESR和CRP显著下降;BMI和白蛋白升高;临床缓解率为80.8%(21/26),内镜下黏膜愈合率为42.3%(11/26),深度缓解率为34.6%(9/26);病程<1年的患者有较高的临床缓解率(92.3%比69.2%,P=0.32).与治疗前相比,治疗后第30周时患者CDAI评分明显下降[225.0(124.0,265.0)分比81.5(67.0,111.0)分,Z=-4.877,P<0.01];ESR和CRP显著下降;BMI和白蛋白升高;临床缓解率为88.5%(23/26),内镜下黏膜愈合率为57.7%(15/26),深度缓解率为53.8%(14/26);病程<1年的患者有较高的临床缓解率(100.0%比76.9%,P=0.22).患者在治疗后第14、30周时临床缓解率、内镜下黏膜愈合率及深度缓解率方面的差异均无统计学意义(P均>0.05).结论 IFX可有效诱导和维持中重度CD患者的深度缓解. 展开更多
关键词 CROHN病 英夫利西 黏膜愈合 临床缓解 深度缓解
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超声内镜引导深挖活检联合黏膜切除术诊治早期直肠类癌 被引量:2
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作者 赵舒畅 庄文侠 +1 位作者 高菲 傅春彬 《临床消化病杂志》 2013年第5期302-304,共3页
目的探讨超声内镜引导下深挖活检早期诊断直肠类癌以及内镜下黏膜切除术治疗直肠类癌的安全性、有效性。方法在超声内镜引导下深挖活检、结合病理及免疫组化检查,诊断直肠类癌24例。对24例直肠类癌的内镜及超声影像特点进行回顾性分析,... 目的探讨超声内镜引导下深挖活检早期诊断直肠类癌以及内镜下黏膜切除术治疗直肠类癌的安全性、有效性。方法在超声内镜引导下深挖活检、结合病理及免疫组化检查,诊断直肠类癌24例。对24例直肠类癌的内镜及超声影像特点进行回顾性分析,总结其特征。对病灶直径小于1.5 cm、浸润深度不超过黏膜下层、无肝转移及腹水发生的直肠类癌采取内镜下黏膜切除术治疗。结果 24例直肠类癌分别距离肛缘5 cm^12 cm,病灶大小0.8cm^1.5 cm,术后切除的标本切缘完整,基底无残留,治疗过程中均未发生穿孔,无迟发性出血,术后创面即刻渗血1例,经内镜治疗血止。随访3至5年无转移及再发。结论直肠类癌可通过超声内镜引导下深挖活检,钳取组织行病理及免疫组化检查而确诊,内镜下黏膜切除术治疗直径小于1.5 cm的直肠类癌简单、安全有效。 展开更多
关键词 超声内镜 直肠类癌 深挖活检 内镜下粘膜切除术
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英夫利西单克隆抗体联合免疫抑制剂短疗程治疗对回结肠型克罗恩病黏膜愈合的疗效
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作者 叶玲娜 李晓林 曹倩 《中华消化杂志》 CAS CSCD 北大核心 2016年第7期471-474,共4页
目的观察短疗程生物制剂英夫利西单克隆抗体(IFX)联合免疫抑制剂治疗活动性回结肠型 CD 患者的疗效,评价治疗后黏膜愈合情况。方法纳入2013年1月至2014年7月规律注射 IFX次数≥6次的活动期回结肠型 CD 住院患者共40例。治疗第0、2、... 目的观察短疗程生物制剂英夫利西单克隆抗体(IFX)联合免疫抑制剂治疗活动性回结肠型 CD 患者的疗效,评价治疗后黏膜愈合情况。方法纳入2013年1月至2014年7月规律注射 IFX次数≥6次的活动期回结肠型 CD 住院患者共40例。治疗第0、2、6周,以5 mg/kg IFX 诱导缓解治疗,在治疗第2周开始合用免疫抑制剂,之后每8周1次维持治疗,治疗第36周为随访终点。治疗前及随访终点比较血 CRP、Hb 水平和临床缓解[(克罗恩病活动指数(CDAI)<150分)]、黏膜愈合[简化内镜下克罗恩病评分系统(SES-CD)为0~2分]率、部分黏膜愈合(SES-CD 较治疗前下降,但是>2分)率和深度缓解(同时达到临床缓解和黏膜愈合)率。治疗前后的比较采用配对 t 检验和 Wilcoxon 符号秩和检验。结果治疗第36周,临床缓解率达95.0%(38/40),黏膜愈合率、部分黏膜愈合率和深度缓解率分别为62.5%(25/40)、35.0%(14/40)和62.5%(25/40),仅1例(2.5%)治疗后黏膜炎性反应没有好转。治疗后的 CDAI 为(99.3±29.3)分,低于治疗前的(301.3±73.1)分,差异有统计学意义(t =17.2,P <0.01)。中位血 CRP 水平为0.8 mg/L(0.1 mg/L,8.1 mg/L),低于治疗前的26.8 mg/L(16.1 mg/L,61.0 mg/L),差异有统计学意义(Z =-5.3,P <0.01),而血 Hb 水平[(134.0±16.0)g/L]高于治疗前[(117.0±20.0)g/L],差异有统计学意义(t=-6.3,P <0.01)。中位 SES-CD 为0分(0分,5分),低于治疗前的14分(8分,24分),差异有统计学意义(Z =-5.4,P <0.01)。结论 IFX 联合免疫抑制剂短疗程(36周)治疗回结肠型 CD 可达到较高的黏膜愈合率和深度缓解率。 展开更多
关键词 CROHN 英夫利西 黏膜愈合 深度缓解
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炎症性肠病治疗目标的演变 被引量:5
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作者 葛文松 《中华消化病与影像杂志(电子版)》 2019年第5期199-202,共4页
炎症性肠病(IBD)目前发病机制未明,可能与环境、遗传、感染、免疫等多种因素有关。IBD的治疗目标最初为临床缓解,随着基础研究进展及新型生物制剂的临床广泛实践,推荐黏膜愈合作为炎症性肠病的重要治疗目标,最近深度缓解作为一个新的治... 炎症性肠病(IBD)目前发病机制未明,可能与环境、遗传、感染、免疫等多种因素有关。IBD的治疗目标最初为临床缓解,随着基础研究进展及新型生物制剂的临床广泛实践,推荐黏膜愈合作为炎症性肠病的重要治疗目标,最近深度缓解作为一个新的治疗目标被提出,在国外已被广泛接受并应用于疾病评估,本文主要介绍炎症性肠病治疗目标的演变及黏膜愈合、深度缓解作为IBD治疗目标的重要意义。 展开更多
关键词 炎症性肠病 溃疡性结肠炎 克罗恩病 黏膜愈合 深度缓解
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