摘要
目的探讨克罗恩病并发肠瘘患者预后的影响因素。方法选择2015年7月至2018年7月本院收治的克罗恩病并发肠瘘患者280例。收集患者一般资料,包括性别、年龄、体质指数、是否合并高血压、是否合并糖尿病、有无吸烟史、是否合并胰腺损伤、有无肛周病变、发病至入院时间、是否长期使用大剂量激素、C反应蛋白水平、红细胞沉降率、有无贫血。采用单因素和多因素Logistic回归分析探讨影响克罗恩病并发肠瘘患者预后的独立危险因素。结果280例克罗恩病并发肠瘘患者随访6个月,预后不良83例,预后良好197例。单因素分析显示,是否合并胰腺损伤、有无肛周病变、发病至入院时间、有无肠外表现及是否长期使用大剂量激素均为克罗恩病并发肠瘘患者预后的影响因素(均P<0.05)。多因素Logistic回归分析显示,合并胰腺损伤、发病至入院时间>12h及长期使用大剂量激素均为影响克罗恩病并发肠瘘患者预后的独立危险因素(均P<0.05)。结论合并胰腺损伤、发病至入院时间>12h及长期使用大剂量激素均为影响克罗恩病并发肠瘘患者预后的独立危险因素,需根据相关影响因素采取针对性预防措施,以改善患者预后。
Objective To explore the prognostic factors of Crohn's disease complicated with intestinal fistula.Method 280 patients with Crohn's disease complicated with intestinal fistula in our hospital from July 2015 to July 2018 were selected as the subjects. General data of patients were collected,including gender,age,body mass index,whether or not the merger with hypertension,diabetes mellitus,smoking history,pancreatic injury,perianal lesions,onset to admission time,long-term use of high-dose hormones,C-reactive protein level,erythrocyte sedimentation rate,and anemia.Univariate and multivariate Logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of Crohn's disease complicated with intestinal fistula.Result The 280 patients with Crohn's disease complicated with intestinal fistula were followed up for 6 months,83 cases had poor prognosis and 197 cases had good prognosis.Univariate analysis showed that the prognostic factors of Crohn's disease complicated with intestinal fistula were whether or not the merger with pancreatic injury,perianal lesions,onset to admission time,parenteral manifestations and long-term use of highdose hormones (all P < 0.05).Multivariate Logistic regression analysis showed that pancreatic injury,onset to admission time > 12 h and long-term use of high-dose hormones were independent risk factors affecting the prognosis of Crohn's disease complicated with intestinal fistula (all P < 0.05).Conclusion Pancreatic injury,onset to admission time > 12 h and long-term use of high-dose hormones are all risk factors affecting the prognosis of Crohn's disease complicated with intestinal fistula,pertinent preventive measures should be taken according to relevant factors,in order to improve the prognosis of patients.
作者
李珍艳
李罗红
李小琼
杨小莉
LI Zhen-yan;LI Luo-hong;LI Xiao-qiong;YANG Xiao-li(Department of Gastroenterology,West China Hospital of SichuanUniversity,Chengdu 610041,China)
出处
《中国医学前沿杂志（电子版）》
2019年第6期103-106,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
克罗恩病
肠瘘
预后
影响因素
Crohn's disease
Intestinal fistula
Prognosis
Influencing factor
