Serum biochemical evaluation of patients with functional pouches ten to 20 years after restorative proctocolectomy.
Serum biochemical evaluation of patients with functional pouches ten to 20 years after restorative proctocolectomy.
复制标题
恢复性直肠结肠切除术后 10 至 20 年具有功能性储袋患者的血清生化评估。
DOI：
10.1007/s00384-005-0076-3
复制
发表时间：
2006
影响因子：
2.8
通讯作者：
M'Koma,AmosyEphreim
中科院分区：
文献类型：
--
作者：
M'Koma,AmosyEphreim
背景：回肠贮袋肛管吻合术是治疗溃疡性结肠炎和家族性腺瘤性息肉病（FAP）的首选手术方式。袋炎是一个重要的神秘的疾病。从长远来看，我们预计，这些患者在保留功能可接受的贮袋数年后会经历生化谱改变。这项试点研究的目的是评估结果的基本生化变量超过10年后surgery.MethodsThe调查进行了91例，39名妇女。其中88人患有溃疡性结肠炎，3人患有FAP。粘膜-直肠结肠切除术后手工缝合的回肠贮器为66 S和25 J。分析比较了短期与长期。患者进行了调查，他们自己的controls.ResultsLong-term，急性和慢性结肠袋炎的发病率分别为2%和13%。11%和4%的患者有低镁血症和低钙血症。平均水平显著提高（p<0.01和p <0.0002）。低镁血症对应于结肠袋炎发作，并通过口服镁和抗生素进行纠正。7%的患者被诊断为缺铁性贫血，并接受口服铁片治疗。慢性贮袋炎和复发性贮袋粘膜出血是其原因。低血红蛋白血症和低氰钴胺血症分别为5%和5%。13%和10%的红细胞沉降率和白色血细胞超出正常范围，这与袋炎相对应。一个显着的（p<0.03）稳定上升的平均血清免疫球蛋白G无相关性pouchitisnoted.ConclusionLong-term的功能结果并没有恶化。袋炎是一个重要的神秘的发病率。重度或慢性结肠袋炎并发缺铁和维生素B12贫血及低镁血症。
BackgroundRestorative proctocolectomy with an ileal pouch–anal anastomosis is a surgical treatment of choice for ulcerative colitis and familial adenomatous polyposis (FAP). Pouchitis is a significant enigmatic morbidity. In the long-term, these patients, we anticipated, would experience biochemical profiling alterations after years of retaining functionally acceptable pouches. This pilot study was aimed at assessing results of essential biochemical variables more than 10 years after surgery.MethodsThe investigation was carried out in 91 patients; 39 were women. Eight-eight had ulcerative colitis, while three had FAPs. The hand-sewn ileal reservoirs after mucoso-proctocolectomy were 66 S and 25 J. The analyses were compared short-term vs long-term. Patients were investigated and were their own control.ResultsLong-term, incidence of acute and chronic pouchitis was 2 and 13%. Eleven and 4% of patients had hypomagnesaemia and hypocalcaemia. Mean levels were significantly enhanced (p<0.01 andp<0.0002). Hypomagnesaemia corresponded to episodes of pouchitis and was corrected with oral magnesium and antibiotics. Hypoferric anaemia was diagnosed in 7% and treated with oral iron tablets. Chronic pouchitis and recurrent pouch mucosa bleeding were the cause. Hypohemoglobinemia and hypocyanocobalaminemia were noted in 5% and 5%, respectively. Erythrocyte sedimentation rate and white blood cells were supra-normal in 13 and 10%, which corresponded with pouchitis. A significant (p<0.03) steady rise of mean serum immunoglobulin G without correlation to pouchitis was noted.ConclusionLong-term functional results did not deteriorate. Pouchitis was a significant enigmatic morbidity. Severe or chronic pouchitis complicated hypoferric and vitamin B12anemia and hypomagnesaemia.