中国实用外科杂志

中国实用外科杂志

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炎症性肠病规范化外科治疗值得注意的几个问题

朱维铭，李    毅   

  1. 南京军区南京总医院 南京大学医学院金陵医院普通外科 炎症性肠病治疗中心，江苏南京210002
  • 出版日期:2017-03-01 发布日期:2017-03-02

  • Online:2017-03-01 Published:2017-03-02

摘要：

近年来，由于药物尤其是生物制剂的不断开发和广泛应用，为炎症性肠病的治疗带来了新的希望和治疗选择。然而，手术仍然是治疗炎症性肠病不可或缺的重要手段，尤其对于复杂炎症性肠病，外科治疗起到核心作用。在外科治疗方面，炎症性肠病区别于胃肠道肿瘤等疾病的最大特点是其缺乏统一规范的围手术期处理方案及手术方式。炎症性肠病病人由于发病年龄、疾病表现、疾病部位及用药史不同，使其具有很强的个体化特点；由于合并肠道狭窄、瘘、腹腔脓肿等并发症，在围手术期处理和手术操作技巧等方面有许多值得研究和探索的空间。

关键词: 炎症性肠病, 围手术期, 并发症

Abstract:

Standardized surgical considerations in the treatment of inflammatory bowel disease        ZHU Wei-ming, LI Yi. Center for Inflammatory Bowel Diseases, Department of General Surgery, General Hospital of Nanjing Military Command of PLA; Nanjing Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
Corresponding author: ZHU Wei-ming, E-mail: juwiming@126.com
Abstract    Despite the development of medical treatment and the rise of biologic therapy， most inflammatory bowel disease patients would ultimately require surgical resection for inducing disease remission. Surgery remains a cornerstone for the management of inflammatory bowel diseases complicated with penetrating, obstructing，or malignant complications. Unlike procedures for colorectal cancer， surgery for inflammatory bowel diseases is much more individualized. Optimal surgical therapy including preoperative optimization and intra-operative maneuvers are important for the presence of intestinal stenosis， fistulae， and abdominal/pelvic abscess.

Key words: inflammatory bowel disease；perioperative period, complications