摘要
克罗恩病是累及消化道的慢性、反复发作和非特异性的透壁性炎症,肠梗阻是其最常见的外科并发症,药物逆转慢性纤维化导致的狭窄性病变作用有限,内镜下扩张术是治疗症状性和短程狭窄的首选方法,使用要素膳的完全肠内营养是安全有效的治疗方法。如果药物、肠内营养以及内镜治疗等非手术疗法不能缓解或者病情复发,则需要手术治疗。术前风险评估非常重要,合并营养不良者建议使用肠内营养进行预康复。手术方式建议首选腹腔镜手术。术后复发的预测、监测与药物预防非常重要。
Crohn’s disease is a chronic, recurrent and transmural inflammation involving the digestive tract, and intestinal obstruction is the most common surgical complication. Drugs have limited effect in reversing the stenosis caused by chronic fibrosis. Endoscopic dilatation is a preferred technique for the management of symptomatic and short strictures. Exclusive enteral nutritional therapy with elemental diet is an effective and safe option to relieve inflammatory bowel stricture. Surgical treatment should be performed to solve intestinal obstruction, if conservative treatment,including drug, enteral nutrition and endoscopy cannot alleviate or obstruction relapse. Preoperative risk assessment is important, and enteral nutrition is recommended for prehabilitation in malnutrition patients, and laparoscopic surgery is recommended. Medical prophylaxis and risk assessment are recommended to reduce post-operative recurrence of CD.
作者
王革非
WANG Ge-fei(Cliniacl Medical School of Nanjing University,Department of General Surgery,General Hospital of Eastern Theater Command/Nanjing General Hospital,Research Institute of General Surgery,PLA,Nanjing 210002,Jiangsu,China)
出处
《肠外与肠内营养》
CSCD
北大核心
2019年第1期1-5,共5页
Parenteral & Enteral Nutrition
基金
国家自然科学基金面上项目(81870396)
江苏省重点研发计划(社会发展)面上项目(BE2017725)
关键词
克罗恩病
肠梗阻
药物治疗
肠内营养治疗
手术
Crohn's disease
Intestinal obstruction
Drug therapy
Enteral nutrition therapy
Surgical treatment
作者简介
王革非,副主任医师,医学博士,从事普通外科专业。E-mail:wgfwang@gmail.com.
