克罗恩病的肠外表现和并发症

目的 分析克罗恩病(CD)伴随的肠外表现和并发症，探讨与病变部位和临床类型之间的关系。方法 采用x^2检验方法对92例CD患者进行回顾性分析。结果 92例CD患者中37例(40.2％)有肠外表现，其中15例(16.3％)有一种以上肠外表现。从大肠、小肠到大小肠同时受累组中，各种肠外表现的发生有增加趋势。有肠外表现各组中，有并发症及手术史者几乎均较无肠外表现组高。并发症的发生率为66.3％，依次为肠梗阻39.1％，肠瘘23.9％，下消化道大出血15.2％，肠穿孔10.9％，败血症5.4％，腹腔脓肿4.3％，肛周疾病4.3％，未见癌变者。多数肠外表现和并发症与疾病活动性相关，肠外表现经氨基水杨酸类和(或)皮质类固醇治疗后多消失，而并发症常需手术治疗。结论 CD肠外表现和并发症发生率较高，多数与疾病活动性相关，并与病变部位、临床类型等有关。

Extra-intestinal manifestations and complications of Crohn disease

Objective To probe the relationship between location and clinical type of Crohn disease (CD) by analyzing its extra intestinal manifestations and complications. Methods Ninety two CD cases from 1980 to 2003 in our hospital were reviewed retrospectively. Results Thirty seven of 92 patients (40.2%) with CD had extra intestinal manifestations, 15 (16.3%) of these patients had more than one extra colonic organ involvement. There was a trend of increasing incidence from the large enteritis to the small enteritis to the extensive enteritis. The incidence of complications and operations in CD with extra intestianl manifestations were greater than that in without extra intesfinal manifastation. The incidence of complications was 66.3% , which includes 39.1% with intestinal obstruction, 23.9% with intestinal fistula, 15.2% with hemorrhage of lower digestive tract, 10.9% with intestinal perforation, 5.4% with septemia, 4.3% with abdominal abscess, 4.3% with perianus disease, and no carcinomatous change was found. Most of the extra intestinal manifestations and complications were associated with active CD, the extra intestinal manifestations could be healed with sulfasalazine and / or steroid treatment, but the complications usually needed to be operated. Conclusions Extra intestinal manifestations and complications commonly occurred in CD. The majority of them were associated with disease activity and closely related with the location and clinical type of CD.