摘要
目的探讨克罗恩病（CD）复发再手术后并发症的危险因素及其疗效。方法回顾性收集1995-2009年间在福建医科大学附属第一医院65例CD复发再手术患者的临床资料（再手术组），对其术后并发症的危险因素进行分析。同时选取同期年龄匹配的65例CD初次手术患者（初次手术组）。比较再手术与初次手术的术中及术后情况。结果再手术组复发再手术后有25例（38．5％）出现并发症，显著高于初次手术者（12．3％）。术中行预防性肠造口的19例患者术后仅3例（15．8％）出现并发症，而未行预防性肠造口的46例患者有22例（47．8％）出现并发症，差异有统计学意义（Х^2=5．831，P=0．016）。与初次手术相比，再手术组手术时间更长、腹膜粘连更严重、术后住院时间更长（均P〈0．05）。结论CD复发再手术术式复杂．有着较高的术后并发症发生率。预防性肠造口有助于降低术后并发症发生率。
Objective To evaluate the risk factors of postoperative complications after reoperation for recurrent Crohn disease （CD）. Methods From 1995 to 2009, 65 patients undergoing reoperation for recurrent CD were identified in the First Affiliated Hospital of Fujan Medical University. Risk factors of postoperative complications were analyzed. These patients were matched by age to 65 patients undergoing primary operation and treatment outcomes were compared between primary operation and reoperation. Results Postoperative complications were observed in 25 cases （38.5%） undergoing reoperation for CD recurrence and the rate of postoperative complication was higher than that after primary operation （12.3%）. Postoperative complications rate in patients with stoma was significantly lower than those without stoma （15.8% vs. 47.8%, Х^2=5.831, P=0.016）. Compared to primary operation, reoperation had longer operative time, more severe intraperitoneal adhesion, and a longer postoperative hospital stay （all P〈0.05）. Conclusion Reoperation for CD recurrence is associated with higher postoperative complications. Temporary stoma may decrease the rate of postoperative complication.
出处
《中华胃肠外科杂志》
CAS
北大核心
2011年第3期181-184,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
克罗恩病
再手术
术后并发症
肠造口
Crohn disease
Reoperation
Postoperative complications
Stoma
