Preoperative exclusive enteral nutrition reduces the postoperative septic complications of fistulizing Crohn's disease
Preoperative exclusive enteral nutrition reduces the postoperative septic complications of fistulizing Crohn's disease
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术前单纯肠内营养可减少瘘管性克罗恩病术后脓毒症并发症
DOI：
10.1038/ejcn.2014.16
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发表时间：
2014-04-01
影响因子：
4.7
通讯作者：
Li, J.
中科院分区：
文献类型：
--
作者：
Li, G.;Ren, J.;Li, J.
背景/目的：独家肠内营养（EEN）已被证明是克罗恩病（CD）管理的有效方法。然而，关于其在肠皮瘘（ECFs）切除术后腹腔内脓毒性并发症（IASCs）中的作用，很少有报道。我们的目的是探讨术前3个月的EEN对间间癌变发生率的影响，并阐明间间癌变的危险因素。研究对象/方法：对2001年2月至2011年4月123例合并ECFs的CD患者进行回顾性研究。55例（44.7%）患者术前3个月接受EEN治疗。比较两组血清白蛋白、c反应蛋白（CRP）的变化。采用logistic回归分析围手术期资料，确定影响术后IASCs发生率的独立危险因素。结果：EEN组和非EEN组患者在性别、年龄、瘘管状况和围手术期用药方面相似。EEN组手术时血清白蛋白水平明显升高，CRP水平明显降低，IASCs发生风险较低(3.6% vs 17.6%， P
BACKGROUND/OBJECTIVES: Exclusive enteral nutrition (EEN) has been shown to be effective in the management of Crohn's disease (CD). However, few experiences have been reported regarding its role in postoperative intra-abdominal septic complications (IASCs) after bowel resections for enterocutaneous fistulas (ECFs). Our aim was to investigate the influence of preoperative 3-month EEN on the incidence of IASCs and to clarify the risk factors of IASCs in fistulizing CD.SUBJECTS/METHODS: A retrospective study on 123 CD patients suffering from ECFs was conducted from February 2001 to April 2011. Fifty-five patients (44.7%) received preoperative 3-month EEN. The changes in serum albumin and C-reactive protein (CRP) were compared. Perioperative data were analyzed using logistic regression to identify the independent risk factors affecting the incidence of postoperative IASCs.RESULTS: Patients were similar in gender, age, fistula conditions and perioperative medications in the EEN and non-EEN groups. The EEN group had a significantly higher serum albumin level and lower CRP at operation, and suffered a lower risk of IASCs (3.6% vs 17.6%, P