CT小肠造影对克罗恩病患者术后复发及复发再手术的评估价值

摘要

Objective To explore the value of CT enterography (CTE) in the assessment of postoperative recurrence and reoperation of Crohn' s disease (CD).Methods Clinical data and postoperative CTE images 72 CD patients undergoing surgery were retrospectively analyzed.Patients were divided into non-recurrence group (NR group,n =6),recurrence-medication group (RM group,n =45)and repeated surgery group (RS group,n =21) according to the clinical outcome during follow up period.The disease activity was evaluated by using a semi-quantitative CTE scoring system ranging from 0 to 3.Differences of CTE scores were compared among NR,RM and RS groups.Kaplan-Meier method was used to examine the cumulative postoperative recurrence and reoperation rate in CD patients.Results Among 72 patients,6 patients were categorized as NR group with all CTE scores of 0;45 were as RM group with median CTE score of 3 (0-3);21 were as RS group with median CTE score of 3 (2-3).There were significant differences in CTE scores among NR,RM and RS group (P ＜ 0.001).The patients with CTE score of 3 showed significantly higher percentage of reoperation than the patients with CTE score of 2 (P ＜0.001).Conclusion CTE can evaluate the postoperative recurrence and provide more informations for the precise personalized therapies in the treatment of CD patients.%目的 探讨术后CT小肠造影(CTE)对克罗恩病(CD)患者术后复发及复发再手术的评估价值.方法 回顾性分析72例经手术治疗CD患者的术后CTE和临床资料,根据随访期间临床结局将其分为未复发组(6例)、复发未手术组(45例)和复发手术组(21例).采用CTE半定量评分系统(0～3分)评估疾病活动性,对比3组之间的CTE评分差异;用Kaplan-Meier曲线分析不同CTE评分患者术后累积再手术率的情况.结果 72例患者中,未复发组均未发现病变,CTE评分均为0分;复发未手术组CTE评分为3(0～3)分;复发手术组CTE评分为3(2～3)分.未复发组、复发未手术组及复发手术组3组的CTE评分差异有统计学意义(P＜0.001).CTE 3分的患者术后再手术的比例高于CTE 2分者(P＜ 0.001).结论 CTE可评估CD患者术后肠道复发的状况,为临床选择个体化的治疗方法提供更多信息.