Clinical Gastroenterology Hepatology :2002年以后克罗恩病患者的再次手术率显着下降

2020-04-06 MedSci原创 MedSci原创

克罗恩病(CD)患者可能需要进行多次腹腔手术,本研究旨在对进行肠外科手术的CD患者再次手术的时间趋势和危险因素进行相关分析。

背景与目标:克罗恩病(CD)患者可能需要进行多次腹腔手术,本研究旨在对进行肠外科手术的CD患者再次手术的时间趋势和危险因素进行相关分析。

方法:研究人员对1982年5月之后在日本10家三级医疗机构接受初次肠切除术的1871名CD患者进行了回顾性分析。研究人员收集了所有患者的背景特征数据,包括蒙特利尔分类,吸烟状况,和手术后的药物治疗(肿瘤坏死因子拮抗剂[anti-TNF]药剂或免疫调节剂)。主要观察结局是需要再次手术情况。使用Kaplan-Meier方法估算再手术率,并使用Cox回归模型确定再次手术的危险因素。

结果:五年和十年的总体累计再手术率分别为23.4%和48.0%。多变量分析显示,与2002年4月之前接受手术的患者相比,2002年5月之后接受初次手术的患者的再手术率显着降低(危险比[HR]为0.72; 95%CI为0.61-0.86)。术前吸烟(HR,1.40; 95%CI,1.18-1.68),肛周疾病(HR,1.50; 95%CI,1.27-1.77)和CD的回盲型(HR,1.42; 95%CI,1.20-1.69)是再次手术的重要危险因素。术后使用免疫调节剂(HR,0.60; 95%CI,0.44-0.81)和抗TNF治疗(HR,0.71; 95%CI,0.57-0.88)显着降低了风险。

结论:2002年5月之后,CD患者的再手术率显着下降。术后使用抗TNF药物可能会降低CD患者的再手术率。

原始出处:

Takahide Shinagawa. Et al. Rate of Reoperation Decreased Significantly After Year 2002 in Patients With Crohn's Disease. Clinical Gastroenterology Hepatology.2020.

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    2020-04-23 ewsr11
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    2020-06-03 许安
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    2020-04-08 gwc384
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    2020-04-08 zll0628

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