43例克罗恩病手术患者蒙特利尔分型特征分析

目的探讨克罗恩病手术患者蒙特利尔分型的临床特点。方法回顾分析43例克罗恩病手术患者（手术组）的临床资料，按蒙特利尔分型标准进行临床分型，对比非手术的克罗恩病患者（非手术组）125例各亚型的临床特征。结果手术组17～40岁（A2）28例（65．1％），大于40岁（A3）者14例（32．6％）。16岁以下（A1）者只有1例；与非手术组比较，差异无统计学意义（P〉0．05）。手术组病变累及回肠末端（E1）18例（41．9％），结肠（TJ2）11例（25．6％），回结肠（L3）13例（30．2％），上消化道（IA）1例（2．3％）；与非手术组比较，差异也无统计学意义（P〉0．05）。疾病行为：手术组无狭窄无穿透（B1）1例（2．3％），狭窄（B2）26例（60．5％），穿透（B3）16例（37．2％）；与非手术组的B1亚型79例（63．2％）、B2亚型44例（35．2％）和B3亚型2例（1．6％）相比，差异有统计学意义（P=0．000、P=0．004和P=0．000）。结论克罗恩病手术患者的年龄和病变部位的亚型与非手术患者相同，但其疾病行为主要为狭窄和穿透亚型．是手术治疗的主要原因。

Analysis of clinical characteristics of 43 surgical patients with Crohn disease using the Montreal classification

Objective To investigate the clinical features of Crohn disease according to the Montreal classification. Methods Clinical data of 43 surgical patients with Crohn disease (surgical group) and 125 non-surgical patients with Crohn disease (non-surgical group) were retrospectively analyzed and compared between two groups. The Montreal classification was used. Results In the surgical group, 28 patients(65.1%) were A2, 14(32.6%) were A3 and only one was A1, which was not significantly different as compared to the non-surgery group. The proportions of L1, L2, L3, and L3 subtype in the surgical group were 41.9%, 25.6%, 30.2%, and 2.3%, respectively, which was not significantly different as compared to that in the non-surgery group. In the surgical group, B1 disease was found in 1 case(2.3%), B2 in 26 cases(60.5%), and B3 in 16 cases(37.2%), while in the non-surgical group, B1 was found in 79 cases (63.2%), B2 in 44 cases (35.2%) and B3 in 2 cases (1.6%).Differences were significant between two groups in disease behavior(P=0.001, P=0.004, P=0.001).Conclusions Most surgical patients of Crohn disease are A2. LI and L3 are the main lesion location.As disease behavior, B2 and B3 are the main reasons for operation.