克罗恩病并发腹腔脓肿的临床特征与外科治疗

目的探讨克罗恩病(CD)合并腹腔脓肿的临床特征和外科治疗及预后。方法对2000-2005年间收治的142例CD患者其中合并腹腔脓肿的39例临床资料进行总结分析。结果本组CD患者合并腹腔脓肿的总发病率为27.5%,从发病到脓肿形成的时间范围为0-22年,平均5年。发病年龄(34.7±12.3)岁。24例(61.5%)患者既往有手术史;30例(76.9%)患者的脓肿发生在右侧腹,尤其是在吻合口附近(48.7%)。36例(92.3%)采取手术治疗,其中34例(34/36,94.4%)行手术引流加病变肠管切除,恢复良好。结论CD有较高的腹腔脓肿并发率,发病年龄多在35岁,将近50%发生在原吻合口;脓肿前的CD病程平均5年;手术方式以脓肿引流加病变肠管切除为主。

Clinical characteristics and surgical treatment of Crohn disease complicated with intra-abdominal abscess

OBJECTIVE: To elucidate the clinical characteristics and surgical treatment of intra-abdominal abscess in patients with Crohn disease(CD). METHODS: Clinical data of 39 patients with CD complicated with intra-abdominal abscess from 2000 to 2005 were analyzed retrospectively. RESULTS: The cumulative incidence of intra-abdominal abscesses was 27.5%. Of the 39 CD patients with abscess, 61.5% had surgery the time of present study. The mean age of the patients with abscesses was (34.7+/- 12.3) years, and the duration of illness from the onset of CD until development of an abscess was (0-22) years,with 5 years of the average duration. In terms of location of abscess, it occurred most often on the right side (76.9%), especially near the site of anastomosis (48.7%). Most patients (34 cases, 94.4%) were treated with surgical drainage and intestinal resection. CONCLUSIONS: Abscess formation was noted in 27.5% of patients with CD, with nearly half of abscesses occurring near the anastomotic site. The mean age of patients with abscess was 35 years, with 5 years of the duration of illness. Most abscesses were treated with operative drainage and intestinal resection.