摘要
目的:回顾分析我科收治的胃十二指肠克罗恩病(CD)病人的病情及其治疗方法。方法:回顾性分析410例CD病人,其中病变累及胃十二指肠的有15例(3.7%)。幽门或球部梗阻者12例,球部溃疡者1例,十二指肠-结肠内瘘2例。结果:除1例术中发现内瘘并修补的病人,其余病人均给予抑酸制剂联合肠内营养治疗,3个月后6例病人症状缓解,1例给予类克(英夫利西单抗)诱导治疗后缓解,3例行内镜下球囊扩张,4例行手术治疗。结论:对于无急诊手术指征的胃十二指肠CD,首选肠内营养联合抑酸治疗,对于有轻度狭窄者,可行内镜下球囊扩张,若最终仍需手术,可行毕Ⅰ式胃部分切除术。
Objective： Gastroduodenal Crohn＇s disease has relatively low incidence,and this study reviewed the therapies of gastroduodenal CD.Methods： 410 CD patients admitted between January 2006 and August 2011 were retrospectively reviewed,and among them 15 patients（3.7%） were gastroduodenal CD,12 pylorus or duodenal stenosis,1 bulbar ulcer,and 2 duodenocolic fistula.Results： Except one patient who was found duodenocolic fistula intraoperatively and repaired,other patients were treated with anti-acid therapy and enteral nutrition therapy.And after three months,six patients had symptoms resolved,one patient received infliximab therapy and resolved,three patients underwent endoscopic balloon dilatation,and four patients had surgery.Conclusion： For gastroduodenal CD without indications for emergent operation,enteral nutrition therapy is the first choice,and endoscopic balloon dilatation is indicated for short stricture.If surgery is needed ultimately,Billroth Ⅰ gastrectomy can be done.
出处
《肠外与肠内营养》
CAS
北大核心
2012年第5期257-259,共3页
Parenteral & Enteral Nutrition
基金
卫生行业科研专项项目资助(201002020)
关键词
胃十二指肠克罗恩病
肠内营养
手术
类克
内镜下扩张
Gastroduodenal Crohn＇s disease
Enternal nutrition
Surgical therapy
Infliximab
Endoscopic balloon dilatation
