关键词： Inflammatory bowel disease   Inflammatory bowel disease type unclassified   Capsule endoscopy   Crohn’s disease   Lewis score   Reclassification  

摘要： AIM To evaluate the role of small bowel capsule endoscopy(SBCE) on the reclassification of colonic inflammatory bowel disease type unclassified(IBDU).METHODS We performed a multicenter, retrospective study including patients with IBDU undergoing SBCE, between 2002 and 2014. SBCE studies were reviewed and the inflammatory activity was evaluated by determining the Lewis score(LS). Inflammatory activity was considered significant and consistent with Crohn's disease(CD) when the LS ≥ 135. The definitive diagnosis during follow-up(minimum 12 mo following SBCE) was based on the combination of clinical, analytical, imaging, endoscopic and histological *** Thirty-six patients were included, 21 females(58%) with mean age at diagnosis of 33 ± 13(15-64) years. The mean follow-up time after the SBCE was 52 ± 41(12-156) mo. The SBCE revealed findings consistent with significant inflammatory activity in the small bowel(LS ≥ 135) in 9 patients(25%); in all of them the diagnosis of CD was confirmed during follow-up. In 27 patients(75%), the SBCE revealed no significant inflammatory activity(LS < 135); among these patients, the diagnosis of Ulcerative Colitis(UC) was established in 16 cases(59.3%), CD in 1 case(3.7%) and 10 patients(37%) maintained a diagnosis of IBDU during follow-up. A LS ≥ 135 at SBCE had a sensitivity = 90%, specificity = 100%, positive predictive value = 100% and negative predictive value = 94% for the diagnosis of *** SBCE proved to be fundamental in the reclassification of patients with IBDU. Absence of significant inflammatory activity in the small intestine allowed exclusion of CD in 94% of cases.

关键词： 白术   肛肠病   临床应用  

摘要： 中医治疗肛肠疾病,提倡内外并重,择机而施。临床运用白术补气健脾的功效治疗肛肠术后肛门坠胀、术后创口愈合缓慢、气虚便血、慢传输型便秘,利用白术燥湿利水的作用,治疗肛肠术后小便不利、脾虚泄泻等取得较好疗效。提出肛肠疾病与脾虚湿盛关系密切,运用白术具有的双向调节作用,师法经方应用之道,通过合理配伍,能极大发挥常用中药的功效。

关键词： 术后大出血   评估   护理干预  

摘要： 为探讨早期出血风险评估及护理干预在预防和减少肛肠疾病术后大出血方面的效果，将肛肠病术后患者792例随机分为评估组和对照组各396例。评估组患者在常规护理基础上早期给予出血风险评估，根据不同出血风险因素，积极给予相应护理干预；对照组患者只接受常规护理。出院1个月后根据2组患者术后大出血率、出血量、出血次数、出血时间及平均住院天数进行评价及对比分析。结果显示，评估组术后大出血发生率、出血量、出血次数、出血时间以及平均住院天数均优于对照组。结果表明，早期出血风险评估及护理干预可以有效预防和减少肛肠病术后大出血的发生。

关键词： 黄龙汤   肺炎   肠疾病   中药疗法  

摘要： 目的观察黄龙汤治疗老年重症肺炎并发中毒性肠麻痹的疗效。方法将40例老年重症肺炎并发中毒性肠麻痹患者随机分为2组,治疗组20例在常规治疗基础上加用黄龙汤,对照组20例予常规治疗。观察治疗前及治疗72 h后肺炎严重度指数(PSI)评分、急性生理与慢性健康评分(APACHEⅡ)、肠鸣音、白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR),并判定疗效。结果治疗组有效率90%,对照组70%,2组比较差异有统计学意义(P<0.05)。2组治疗后PSI、APACHEⅡ评分均明显降低(P<0.05);治疗组治疗后PSI、APACHEⅡ评分低于对照组,但二者比较差异无统计学意义(P>0.05)。2组治疗后hs-CRP及ESR较治疗前均降低(P<0.05);治疗组治疗后hs-CRP及ESR均低于对照组(P<0.05)。治疗组治疗后WBC较治疗前降低(P<0.05),对照组治疗前后WBC比较差异无统计学意义(P>0.05)。结论黄龙汤是治疗老年重症肺炎并发中毒性肠麻痹的一种有效方法,可有效改善炎症。

关键词： 小肠疾病   造影检查   多层螺旋CT口服法   应用效果  

摘要： 目的评估应用多层螺旋CT口服法对小肠疾病展开小肠造影检查的诊断效果。方法随机选取2014年7月—2016年7月因疑似患有小肠疾病进入该院施行相应诊疗的78例患者为研究对象,在掌握其常规指标的前提下,应用多层螺旋CT口服法对入选病例开展小肠造影的系统化检查,经回顾各项造影征象及医疗数据后,评估此法用于小肠疾病鉴别的效果情况。结果 78例都顺利接受16层螺旋式CT扫描,服用泛影葡胺后未见显著不适感。经手术后病理学证实及对比评估知:16层螺旋CT扫描所得结果的定位正确率、定性正确率分别是84.62%、58.97%;胃肠内镜探查所得结果的定位正确率、定性正确率分别是57.69%、75.64%。统计学处理可知,16层螺旋CT扫描的定位准确率高于胃肠内镜,定性正确率低于胃肠内镜探查,对比差异有统计学意义(P<0.05)。结论多层螺旋CT口服法应用在小肠病变造影扫描操作中,能提升小肠疾病的定位正确率,且患者不适感少,效果较佳。

关键词： INFLAMMATORY bowel diseases   PATIENTS   INFORMATION resources   PATIENT education   ANXIETY   MENTAL depression  

摘要： Background Patient education forms a cornerstone of management of inflammatory bowel disease (IBD). The Internet has opened new avenues for information gathering. Aim To determine the relationship between different information sources and patient knowledge and anxiety in patients with IBD. Methods The use of information sources in patients with IBD was examined via questionnaire. Anxiety was assessed with the hospital anxiety and depression scale and disease-related patient knowledge with the Crohn's and colitis knowledge score questionnaires. Associations between these outcomes and demographics, disease-related factors, and use of different information sources were analysed using linear regression analysis. Results Of 307 patients (165 Crohn's disease, 142 ulcerative colitis) 60.6% were female. Participants used the hospital IBD team (82.3%), official leaflets (59.5%), and official websites (53.5%) most frequently in contrast to alternative health websites (9%). University education (P < 0.001), use of immunosuppressants (P = 0.025), Crohn's and Colitis UK membership (P = 0.001), frequent use of the hospital IBD team (P = 0.032), and frequent use of official information websites (P = 0.005) were associated with higher disease-related patient knowledge. Female sex (P = 0.004), clinically active disease (P < 0.001), frequent use of general practitioners (P = 0.014), alternative health websites (homoeopathy, nutritionists, etc.) (P = 0.004) and random links (P = 0.016) were independently associated with higher anxiety. Conclusions Different patient information sources are associated with better knowledge or worse anxiety levels. Face-to-face education and written information materials remain the first line of patient education. Patients should be guided towards official information websites and warned about the association between the use of alternative health websites or random links and anxiety.

关键词： Inflammatory Bowel Disease, IBD   Radiation proctitis   Radiation induced bowel toxicity  

摘要： Aim: The study's aim was to examine the clinical impact of radiation therapy (RT) on GI toxicity in Inflammatory Bowel Disease (IBD) patients. Background: IBD has long been considered a risk factor for increased bowel toxicity from RT;however, minimal evidence exists on patients with prostate cancer (PC) and IBD. Materials and methods: The tumor registry was queried for patients with IBD and PC from the years 1990-2013. A retrospective review was conducted for patients who received RT. Radiation treatment and toxicity data were collected. Results: Average length of follow-up was 12 years (median 9.54, range 0.42-19.9). The majority had well controlled baseline bowel function on medical management. Prior to radiation, 60% of patients (9/15) and 40% (6/15) reported grade 0 (GO) and grade (G1) diarrhea at baseline, respectively. No baseline proctitis existed. Following radiation treatment, 78% (14/18) of patients experienced GO diarrhea while 22% (4/18) reported G1 diarrhea. No patients suffered from greater than G1 diarrhea. Sixty-six percent (12/18), 17% (3/18) and 17% (3/18) of patients experienced GO, G1, and G2 proctitis, respectively. No patients suffered post-radiation stricture formation, and all patients with G2 proctitis received 3dCRT. Conclusions: Limited published data is available exploring RT for patients with PC and IBD. This analysis offers valuable insight into appropriate counseling for a rare patient subset. Radiation improved late G1 diarrhea rates. Grade 2 proctitis was only encountered in 3dCRT patients. No post-radiation complications occurred. Our findings suggest that IBD patients experience minimal toxicity in the era of IMRT based RT. (C) 2016 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved.

关键词： Inflammatory bowel disease   Crohn's disease   Indomethacin   Mesalazine   p-Nitrophenol  

摘要： Morphological and functional changes have been investigated in the rat model of Crohn's disease. The inflammatory bowel disease was induced by indomethacin (1 x 10 mg/kg s.c. for 3 days). Morphological alterations were evaluated by macroscopic scoring system and on the base of histological changes in the small intestine. Functional activities were studied by determination of the intestinal and hepatic elimination of p-Nitrophenol (PNP) and its metabolites (PNP-glucuronide: PNP-G and PNP-sulfate: PNP-S) during the luminal perfusion of PNP. It was found that the indomethacin induced severe macroscopic changes (hyperaemia, petechia, bleeding, erosions, ulcerations) and significant histological alterations in the small intestine of rats which were definitely inhibited by mesalazine (1000 mg/kg by gastric tube for 3 days). Disappearance of PNP from the luminal perfusion solution was diminished by indomethacin which was corrected by administration of mesalazine. Significant depression was found in the luminal appearance of PNP metabolites by giving of indomethacin and these alterations could not be compensated by mesalazine. Hepatic elimination of PNP (biliary excretion of PNP and its metabolites) was decreased definitely by indomethacin which was - at least partly - compensated by mesalazine. The findings of the present study suggest that the indomethacin-induced inflammation in the small intestine represents a useful rat model of Crohn's disease. Morphological and functional alterations caused by indomethacin can be compensated by mesalazine.

关键词： Patient and public involvement   research methodology   research priorities   bowel disease   outcome selection   priority setting partnership  

摘要： Aim There is a recognized need to include the views of patients and the public in prioritizing health research. This study aimed: (i) to explore patients' views on colorectal research;and (ii) to prioritize research topics with patients and the public. Method In phase 1, 12 charitable organizations and patient groups with an interest in bowel disease were invited to attend a consultation exercise. Participants were briefed on 25 colorectal research topics prioritized by members of the Association of Coloproctology of Great Britain and Ireland. Focus groups were conducted and discussions were recorded with field notes. Analysis was conducted using principles of thematic analysis. In phase 2, a free public consultation was undertaken. Participants were recruited from newspaper advertisements, were briefed on the same research topics and were asked to rate the importance of each on a five-point Likert scale. Descriptive statistics were used to rank the topics. Univariable linear regression compared recorded demographic details with mean topic scores. Results Focus groups were attended by 12 patients who highlighted the importance of patient-centred information for trial recruitment and when selecting outcome measures. Some 360 people attended the public consultation, of whom 277 (77%) were recruited. Participants rated 'What is the best way to treat early cancer in the back passage?' highest, with 227 (85%) scoring it 4 or 5. There was no correlation between participant demographics and mean topic scores. Conclusion The present study prioritized a colorectal research agenda with the input of patients and the public. Further research is required to translate this agenda into real improvements in patient care.