Dig Dis Sci: 行回肠肛管吻合术的溃疡性结肠炎患者感染难治性梭状芽胞杆菌和巨细胞病毒的复发率分析

2021-01-15 MedSci原创 MedSci原创

溃疡性结肠炎(UC)是一种炎症性肠疾病,积极使用生物疗法已将UC的手术率降低到约25%,但是,仍有大量患者需要手术干预。

      溃疡性结肠炎(UC)是一种炎症性肠疾病,积极使用生物疗法已将UC的手术率降低到约25%,但是,仍有大量患者需要手术干预。回肠肛管吻合(IPAA)为UC的一般手术方式,与没有炎症性肠病的患者相比,甚至与患有克罗恩病的患者相比,UC患者经过手术以后会机会性感染如艰难梭菌感染(CDI)和巨细胞病毒(CMV)总体发生率更高。CDI和CMV感染率及其对手术结果和最终储袋功能的影响仍存在争议。因此,这项研究的主要目的是评估进行UC手术的患者中CDI和CMV复发的感染率。次要目的是确定在接受UC手术的CDI或CMV感染病史的患者中,抗生素预防措施是否能预防CDI或CMV复发。

 

 

      对于本项研究,研究人员收集了2001年至2017年间在两个医疗中心接受IPAA的所有UC患者的手术及临床数据。主要观察结果是进行手术前的UC患者的艰难梭菌或CMV结肠炎病史以及IPAA术后复发的情况。

 

 

      本项研究共纳入633例接受IPAA的UC患者,其中8.1%的患者患有艰难梭菌,而2.7%的患者患有CMV感染。IPAA后有所有人群中有9.8%的艰难梭菌和5.9%的CMV患者复发。腹部败血症(14.7%vs. 12.7%),90天死亡率(0%vs. 0.4%),储袋炎(36.8%vs.45.0%)或造口率(7.4%vs.5.4%)的发生率在有或没有感染的患者之间没有差异。

 

   

      本项研究证实在接受IPAA手术的UC患者中,艰难梭菌和CMV感染率仍然很高,在随后的外科手术过程中,相当一部分人反复感染。有艰难梭菌病史的患者进行抗生素预防可降低复发感染率。

 

 

原始出处:

Jonathan Pastrana Del Valle. Et al. Recurrence of Clostridium Difficile and Cytomegalovirus Infections in Patients with Ulcerative Colitis Who Undergo Ileal Pouch-Anal Anastomosis. Digestive Diseases and Sciences.2021.

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    2021-02-26 nymo
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    2021-10-18 zhaojie88
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encryptionId=37643946566, topicName=吻合术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b92500139, createdName=12498b37m72暂无昵称, createdTime=Tue Jul 27 01:28:46 CST 2021, time=2021-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502290, encodeId=94ee150229022, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Sun Jan 17 08:28:46 CST 2021, time=2021-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511371, encodeId=fff915113e13a, content=<a href='/topic/show?id=d47d40542cc' target=_blank style='color:#2F92EE;'>#回肠#</a>, beContent=null, objectType=article, 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href='/topic/show?id=687410414e71' target=_blank style='color:#2F92EE;'>#难治性梭状芽胞杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104147, encryptionId=687410414e71, topicName=难治性梭状芽胞杆菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jan 15 19:44:47 CST 2021, time=2021-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916986, encodeId=0f369169865d, content=<a href='/topic/show?id=7f171041465e' target=_blank style='color:#2F92EE;'># 溃疡性结肠炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104146, encryptionId=7f171041465e, topicName= 溃疡性结肠炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jan 15 19:44:27 CST 2021, time=2021-01-15, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1695217, encodeId=b36f169521e65, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Fri Feb 26 21:28:46 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922438, encodeId=d8db192243843, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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href='/topic/show?id=687410414e71' target=_blank style='color:#2F92EE;'>#难治性梭状芽胞杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104147, encryptionId=687410414e71, topicName=难治性梭状芽胞杆菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jan 15 19:44:47 CST 2021, time=2021-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916986, encodeId=0f369169865d, content=<a href='/topic/show?id=7f171041465e' target=_blank style='color:#2F92EE;'># 溃疡性结肠炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104146, encryptionId=7f171041465e, topicName= 溃疡性结肠炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jan 15 19:44:27 CST 2021, time=2021-01-15, status=1, ipAttribution=)]
    2021-01-17 wwzzly
  6. [GetPortalCommentsPageByObjectIdResponse(id=1695217, encodeId=b36f169521e65, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Fri Feb 26 21:28:46 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922438, encodeId=d8db192243843, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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href='/topic/show?id=687410414e71' target=_blank style='color:#2F92EE;'>#难治性梭状芽胞杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104147, encryptionId=687410414e71, topicName=难治性梭状芽胞杆菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jan 15 19:44:47 CST 2021, time=2021-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916986, encodeId=0f369169865d, content=<a href='/topic/show?id=7f171041465e' target=_blank style='color:#2F92EE;'># 溃疡性结肠炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104146, encryptionId=7f171041465e, topicName= 溃疡性结肠炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jan 15 19:44:27 CST 2021, time=2021-01-15, status=1, ipAttribution=)]
    2021-01-17 Tamikia
  7. [GetPortalCommentsPageByObjectIdResponse(id=1695217, encodeId=b36f169521e65, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Fri Feb 26 21:28:46 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922438, encodeId=d8db192243843, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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time=2021-01-15, status=1, ipAttribution=)]
    2021-01-17 freve
  8. 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