Crohn's disease of the distal ileum.
Crohn's disease of the distal ileum.
复制标题
回肠远端克罗恩病。
作者：
C. Higgens;R. Allan
在1944年至1978年的长期回顾中，对227例涉及回肠远端的克罗恩病患者进行了连续的临床和统计分析。我们已经确定了长期预后，每次切除后的累积再手术率，死亡率及其原因。精算分析表明，第一次、第二次和第三次切除后的再手术率相似。没有证据表明额外的手术会增加更多切除的风险。再手术率受基础克罗恩病诊断时年龄的影响很小。从克罗恩病的诊断到首次切除的短时间间隔倾向于增加短期内的再手术率，但没有总体的长期影响。与一般人群相比，死亡风险增加了两倍。一半的死亡与潜在的克罗恩病无关，在该组中，发病率和原因与年龄、性别和风险年相匹配的一般人群中的预期相似。在与疾病有关的死亡中，许多发生在早年。在过去的10年里，该系列中只有4名患者死于克罗恩病。193例患者在诊断为克罗恩病后平均间隔16.1年仍存活。185人的全部信息可用，其中161人情况良好，无症状。7人有小问题，17人身体不适（9人有放射学证据表明疾病复发）。
A clinical and statistical analysis has been undertaken in a consecutive series of 227 patients with Crohn's disease involving the distal ileum under long-term review between 1944 and 1978. We have determined the long-term prognosis, cumulative reoperation rates after each resection, mortality rates, and their causes. Actuarial analysis has shown that the reoperation rates are similar after first, second, and third resections. There was no evidence that additional operations increase the risk of yet more resections. Reoperation rates were very little influenced by the age at diagnosis of the underlying Crohn's disease. A short interval from diagnosis of Crohn's disease to the first resection tended to increase the reoperation rate in the short term but there was no overall long-term effect. There was a two-fold increase in mortality risk when compared with the general population. Half the deaths were unrelated to the underlying Crohn's disease and, in this group, the incidence and causes were similar to those expected in the general population matched for age, sex, and years at risk. Of the disease related deaths many occurred in the early years of experience. Only four patients in the series have died of Crohn's disease in the last 10 years. One hundred and ninety-three patients are still alive after a mean interval of 16.1 years from the diagnosis of Crohn's disease. Full information is available on 185, of whom 161 are well and symptom free. Seven have minor problems, while 17 are unwell (nine with radiological evidence of recurrent disease).