Gastroenterology Report:术前全胃肠外营养改善了接受大腹部手术的克罗恩病患者的术后结果

2019-06-27 不详 MedSci原创

尽管克罗恩病(CD)的治疗方案取得了很大的进步,但很大一部分患者需要在发病5年内进行手术。营养不良是胃肠道手术后不良术后结果的独立危险因素。因此本项研究的目的是确定术前TPN在该人群中的作用。

背景及目的
尽管克罗恩病(CD)的治疗方案取得了很大的进步,但很大一部分患者需要在发病5年内进行手术。营养不良是肠道手术后不良术后结果的独立危险因素。因此本项研究的目的是确定术前TPN在该人群中的作用。

方法
这是一项回顾性队列研究。研究人员将接受腹部手术的CD患者纳入本项研究。将接受术前TPN的患者与对照组患者进行比较,主要观察结果是两组间30天感染和非感染性术后并发症的发生率。

结果
在2007年3月至2017年3月期间,共有144名CD患者接受了腹部手术。将55名接受术前TPN的患者与89名对照组患者进行比较。21例(14.6%)患者出现感染性并发症(TPN组为18.2%,非TPN组为12.3%,P = 0.34),23例(15.9%)出现非感染性并发症(TPN组为14.5%,非TPN组为16.9%,P = 0.71)。在多变量分析中,接受术前TPN≥60天的患者发生非感染性并发症的几率显着降低(优势比0.07,95%置信区间:0.01-0.80 ,P=0.03)。过去6个月体重减轻> 10%是术后并发症的重要预测指标。

结论
在一部分营养不良的CD患者中,TPN是安全的,术前TPN≥60天可减少术后非感染性并发症,而不会增加感染性并发症。

原始出处:

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    2020-04-30 许安
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    2019-06-28 百草

    666

    0

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Dig Liver Dis: 生物制剂使用时小肠克罗恩病狭窄成形术后早期复发的影响因素

存在肠腔狭窄的患者经常会行狭窄成形术来缓解梗阻情况,但是在狭窄部位的克罗恩病早期易于复发,因此,本项研究的目的是探究原发性狭窄成形术后早期再次手术复发的危险因素。

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尽管克罗恩病(CD)的治疗模式剂效果取得了重大进展,但很大一部分患者需要在诊断后5年内进行手术治疗。营养不良是胃肠道手术后不良术后结果的独立危险因素。关于CD患者术前全肠外营养(TPN)价值目前还有争论,因此,本项研究的目的是确定术前TPN在该人群中的作用。

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克罗恩病患者行外科手术治疗后易出现术后早期并发症,因此,本研究旨在探究克罗恩病相关肠切除术后早期术后并发症的患病率和危险因素。

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