Clinical features and long-term survival in chronic intestinal pseudo-obstruction and enteric dysmotility
Clinical features and long-term survival in chronic intestinal pseudo-obstruction and enteric dysmotility
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DOI：
10.1080/00365520902839642
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发表时间：
2009-01-01
影响因子：
1.9
通讯作者：
Tornblom, Hans
中科院分区：
文献类型：
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作者：
Lindberg, Greger;Iwarzon, Marie;Tornblom, Hans
Objective.慢性假性肠梗阻（CIP）是肠动力障碍的最严重形式。肠动力障碍（艾德）已被提出作为一个新的诊断标签，患者的肠动力障碍和严重的症状，但没有放射学迹象的假性梗阻。本研究的目的是比较CIP和ED患者的临床特征、小肠测压结果和长期生存率。在1987年至2002年的16年期间收集的数据进行了回顾性分析，并通过2007年在三级转诊中心的后续行动。该研究包括55例CIP患者（41例F，中位年龄42岁，范围23-76）和70例ED患者（63例F，中位年龄39岁，范围18-71）。中位观察时间为9.9年（范围5.2-20.1）。CIP组死亡19例（35%），艾德组死亡9例（13%）。艾德患者的生存率显著更好（p 0.05）。CIP患者（49%）比艾德患者（14%）更常需要肠外营养。小肠测压显示两组有相似的异常，但CIP组中有16/43例患者没有进食运动反应，而艾德组中没有（p <0.001），持续的不协调阶段性活动更常见CIP患者（23/45）比艾德患者（19/70）的运动功能差（p <0.05），仅在7例CIP患者中观察到重度运动功能减退。结论. CIP和艾德在可测量的生理紊乱的严重程度、营养需求和长期预后方面不同。我们的研究结果表明，CIP和艾德是不同的实体，需要不同的方法来管理。
Objective. Chronic intestinal pseudo-obstruction (CIP) is the most severe form of intestinal dysmotility. Enteric dysmotility (ED) has been proposed as a new diagnostic label for patients with disturbed intestinal motility and severe symptoms but no radiological signs of pseudo-obstruction. The purpose of this study was to compare the clinical features, small-bowel manometry findings and long-term survival in patients with CIP and ED. Material and methods. Data collected during a 16-year period from 1987 to 2002 were retrospectively analysed and followed-up through 2007 in a tertiary referral centre. The study comprised 55 patients (41 F, median age 42 years, range 23-76) with CIP and 70 patients (63 F, median age 39 years, range 18-71) with ED. Results. The median observation time was 9.9 years (range 5.2-20.1). Nineteen patients with CIP (35%) and 9 patients with ED (13%) died. Survival among patients with ED was significantly better (p0.05). Patients with CIP (49%) needed parenteral nutrition more often than patients with ED (14%). Small-bowel manometry showed similar abnormalities in the two groups but absence of a fed motor response to meals was seen in 16/43 patients with CIP compared to none with ED (p0.001), sustained periods of uncoordinated phasic activity were more common (p0.05) in CIP patients (23/45) than in ED patients (19/70) and severe hypomotility was only seen in 7 patients with CIP. Conclusions. CIP and ED differ with respect to severity of measurable physiological derangement, nutritional needs and long-term prognosis. Our findings indicate that CIP and ED are different entities that require different approaches to management.