手术是溃疡性结肠炎(UC)内科治疗无效或发生严重并发症者的治疗选择.目的:分析UC患者行手术治疗的可能预测因素.方法:纳入1998年8月～2009年9月北京协和医院住院UC患者312例,其中34例接受手术治疗,278例接受非手术治疗,回顾性分析、比较两组患者的各类临床资料.结果:住院UC患者手术率为10.9%,手术死亡率为5.9%,重度UC患者手术率为23.9%.手术组13例患者为激素抵抗,8例为激素依赖,9例发生严重并发症,4例激素治疗有效者主动要求手术治疗.手术组平均住院次数显著多于非手术组(P<0.05),术前Hb、白蛋白显著低于非手术组(P<0.05),CRP显著高于非手术组(P<0.05),重度结肠炎、全结肠炎患者比例显著高于非手术组(P<0.05).结论:疾病严重程度高、病变范围广、对激素抵抗的UC患者,手术需求增加.%Surgery is a treatment option for ulcerative colitis (UC) patients with no response to medical treatment or having serious complications. Aims: To analyze the possible predictive factors for surgical therapy in UC patients. Methods: Clinical data of 312 UC in-patients, including 34 surgically treated patients and 278 non-surgically treated patients from Aug. 1998 to Sep. 2009 in Peking Union Medical College Hospital were analyzed retrospectively. Results: The surgical treatment rate in UC in-patients was 10.9%, and the mortality was 5.9%. The surgical treatment rate in patients with severe UC was 23.9% . Of the surgically treated patients, 13 were steroid-resistance, 8 were steroid-dependence, 9 had severe complications, and 4 with response to steroids requested surgery. Frequency of hospitalization was much higher in surgically treated group than that in non-surgically treated group (P<0.05). Preoperative hemoglobin and albumin in surgically treated group were significantly lower than those in non-surgically treated group (P<0.05), while CRP was significantly higher than that in non-surgically treated group (P<0.05). Proportions of patients with severe disease and pan-colitis in surgically treated group were significantly higher than those in non-surgically treated group (P<0.05). Conclusions: UC patients with severe disease, wide range of intestinal segment involvement and resistant to steroids, have an increased requirement for surgical therapy.
展开▼
