克罗恩病外科治疗85例分析

目的总结分析肠道克罗恩病（CD）的外科治疗策略。方法对1980—2005年收治的85例CD病人资料进行回顾性分析。结果近年来CD病人呈增多趋势，术前确诊率为23．53％。肠梗阻（25．88％）、右下腹包块（回盲部肿物，10．59％）、盲肠癌（12．94％）、急性阑尾炎（4．71％）是术前误诊的几大主要原因。手术方式以右半结肠切除术（37．65％），小肠部分切除（21．18％）为主，内、外瘘及肛周CD行外科处理预后良好。结论手术仍是目前肠道CD的重要治疗手段；手术方式依病变部位和并发症类型不同而有差异，术式选择和规范化手术操作是亟待解决的问题。

Surgical treatment of Crohn's disease: a report of 85 cases

Objective To analyze the surgical treatment of Crohn's disease(CD).Methods The clinical data of 85 cases of Crohn's disease admitted between 1980 and 2005 were analyzed retrospectively.Results The number of inpatient with CD increased significantly in recent years.The rate of pre-operation diagnosis was 23.53%.Ileus(25.88%),mass in the right abdomen(10.59%),cecum cancer(12.94%)and acute appendicitis(4.71%)were the most common causes of misdiagnosis before operation.The most surgical procedure was the right half colon resection(37.65%).The second was partial enterectomy(21.18%).The prognosis of enteral and external fistula and perianal CD were satisfactory.Conclusion Surgical treatment is an important means to treat CD.The timely diagnosis and reasonable medical management are helpful to decrease the chance of operation when the lesion is active.It can improve the prognosis significantly.The main surgical signs of CD include obstruction,abdomen mass,fistula,acute perforation,hemorrhage and perianal lesions,etc.The surgical patterns are related to the location of lesion and type of the complication.The research of surgical patterns and standardization is the clinical issue to be resolved urgently.