Prevalence and outcome of anemia after restorative proctocolectomy: a clinical literature review.
Prevalence and outcome of anemia after restorative proctocolectomy: a clinical literature review.
复制标题
恢复性直肠结肠切除术后贫血的患病率和结果：临床文献综述。
DOI：
10.1007/dcr.0b013e31819ed571
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发表时间：
2009
影响因子：
3.9
通讯作者：
Herline,AlanJ
中科院分区：
文献类型：
--
作者：
M'Koma,AmosyE;Wise,PaulE;Schwartz,DavidA;Muldoon,RobertaL;Herline,AlanJ
目的：铁和/或维生素B 12缺乏性贫血，对患者的生活质量有不良影响，是修复性直肠结肠切除术后常见的并发症，也常常被忽视。我们对关于贫血患病率以及贫血对恢复性直肠结肠切除术患者的临床、功能、生活质量和经济结局的影响的出版物进行了系统评价。这些信息对于帮助医疗保健提供者通过全面的概述来提高对可能需要治疗的疾病的认识以改善患者的医疗保健和生活质量非常重要。我们回顾了关于恢复性直肠结肠切除术后贫血发生率及其不良反应的英文出版物，美国国家医学图书馆数据库（MEDLINE），Excerpta Medica数据库（EMBASE），Cochran图书馆，和Google®搜索引擎中搜索关于贫血的患病率和影响的已发表文章，结果：RPC术后最常见的长期并发症是结肠袋炎。袋炎与袋粘膜出血引起的缺铁性贫血显著相关。其他原因是铁吸收不足和/或受损。然而，也有人观察到，恢复性直肠结肠切除术患者与潜在的家族性腺瘤性息肉病很少发生结肠袋炎，但表现出更高的缺铁性贫血的发生率相比，那些患者与潜在的溃疡性结肠炎。在恢复性直肠结肠切除术患者中，作为缺铁性贫血独立危险因素的其他原因是恶性肿瘤、硬纤维瘤和J型囊构型。维生素B 12缺乏性贫血在恢复性直肠结肠切除术后也很常见。大约三分之一的恢复性直肠结肠切除术患者表现出异常的希林试验，5%的患者血清钴胺素水平较低。已经观察到，末端回肠的切除程度、吸收不良、细菌过度生长和饮食因素是钴胺素缺乏症的已知原因。叶酸缺乏症尚未报告在恢复性直肠结肠切除术患者。描述恢复性直肠结肠切除术手术及其结果，在没有贫血的患者，生活质量的报告优秀，无论手术technique.CONCLUSIONS：贫血是不常见的恢复性直肠结肠切除术后，已被证明有负面影响，对患者的生活质量和经济，并可能大幅增加医疗费用。贫血及其根本原因的治疗对于改善临床和经济结果非常重要。
PURPOSE:Iron and/or vitamin B 12 deficiency anemias, which have adverse effects on patients' quality of life, are commonly observed and often overlooked complications after restorative proctocolectomy. We performed a systematic review of publications on the prevalence of anemia as well as on the impact of anemia on a range of clinical, functional, quality of life, and economic outcomes in restorative proctocolectomy patients. This information is important to help healthcare providers through a comprehensive overview to increase awareness about a condition that could require therapy to improve patient healthcare and quality of life.METHODS:We reviewed the English language publications on the incidence of anemia and its adverse effect after restorative proctocolectomy The United States National Library of Medicine database (MEDLINE), the Excerpta Medica database (EMBASE), the Cochran Library, and the Google® search engine were searched for published articles on the prevalence and impact of anemia in post-restorative proctocolectomy surgical patients.RESULTS:The long-term complication most frequently described after RPC is pouchitis. Pouchitis is significantly associated with iron deficiency anemia caused by pouch mucosal bleeding. Other causes are insufficient and/or impaired iron absorption. It has also been observed, however, that restorative proctocolectomy patients with underlying familial adenomatous polyposis rarely develop pouchitis yet show higher rates of iron deficiency anemia compared to those patients with underlying ulcerative colitis. Other causes shown as independent risk factors for iron deficiency anemia in restorative proctocolectomy patients are malignancy, desmoid tumors, and J-pouch configuration. Vitamin B 12 deficiency anemia is also common after restorative proctocolectomy. About one-third of restorative proctocolectomy patients show abnormal Schilling test and 5 percent have low referenced serum cobalamin. It has been observed that the degree resection of the terminal-ileum, malabsorption, bacterial overgrowth, and dietary factors are among the known causes of cobalamin deficiency. Folate deficiency has not been reported in restorative proctocolectomy patients. Describing restorative proctocolectomy surgery and its outcomes, in patients without anemia, the quality of life is reported excellent regardless of operative technique.CONCLUSIONS:Anemia is not uncommon following restorative proctocolectomy and has been shown to have negative effects on the patient's quality of life and the economy and may substantially increase healthcare costs. The treatment of anemia and its underlying causes is important to improving clinical and economic outcomes.