关键词： COVID-19   SARS-CoV-2   Inflammatory bowel disease   Crohn’s disease   Ulcerative colitis  

摘要： Since the initial coronavirus disease 2019(COVID-19)outbreak in China in December 2019,the infection has now become the biggest medical issue of modern *** major contributors that amplified the impact of the disease and subsequently increased the burden on health care systems were high mortality among patients with multiple co-morbidities and overcapacity of intensive care *** the gastroenterology-related community,particular concern was raised with respect to patients with inflammatory bowel disease(IBD),as those patients are prone to opportunistic infections mainly owing to their immunosuppressive-based ***,we sought to summarize current knowledge regarding COVID-19 infection in patients with ***,it seems that IBD is not a comorbidity that poses an increased risk for COVID-19 acquisition,except in patients treated with ***,outcomes of the infected patients are largely dependent on therapeutic modality by which they are treated,as some worsen the clinical course of COVID-19 infection,whereas others seem to dampen the detrimental effects of ***,we discussed the present and the future impact of COVID-19 pandemic and concomitantly increased health care burden on IBD-management.

关键词： Crohn’s disease   Inflammatory bowel disease-knowledge inventory device   Knowledge   Parents   Ulcerative colitis  

摘要： BACKGROUND Disease knowledge is associated with increased treatment compliance and improvement of symptoms in inflammatory bowel disease(IBD).IBD-knowledge inventory device(IBD-KID)was developed and validated specifically as a tool to measure disease-related knowledge in children with IBD and their *** To prospectively assess the determinants of disease-related knowledge regarding paediatric IBD patients and their parents,using the *** A questionnaire-based survey was carried out in paediatric patients and their *** determinants of patients’and parents’IBD-KID scores were assessed according to hierarchical linear regression *** The study group consisted of 269 IBD patients and 298 *** patients’mean(standard deviation,SD)IBD-KID score was 10.87(±3.97),while the parents’was 11.95(±3.97).Both groups exhibited poor knowledge of the side effects of steroid therapy,the role of surgical treatment in IBD,dietary restrictions and the risks associated with the use of herbal *** patients’IBD-KID scores were statistically associated with patient sex[B coefficient(standard error,SE)=1.03(0.44),P=0.021]and patient age[B(SE)=0.03(0.01),P<0.001].The parents’IBD-KID scores were significantly related to patient age[B(SE)=0.02(0.01),P=0.003],and treatment with immunosuppressive agent[B(SE)=1.85(0.48),P<0.001].The final models explained 26.9%of the variance of patients’IBD-KID scores and 18.5%of the variance of parents’*** The variables originating from parents’knowledge were significantly associated with patients’IBD-KID *** study results indicate the need to implement better education programmes for patients and parents.

关键词： Hepatitis B virus   Inflammatory bowel disease   Reactivation   Immunosuppression   Vaccination   Prophylaxis  

摘要： Hepatitis B remains a significant global clinical problem,despite the implementation of safe and effective vaccination *** prevalence of hepatitis B virus(HBV)in patients with inflammatory bowel disease(IBD)largely follows the regional epidemiologic *** screening with hepatitis B surface antigen(HBsAg),and antibodies to hepatitis B surface(anti-HBs)and core(anti-HBc)proteins is a key element in the management of IBD patients and,ideally,should be performed at IBD *** of individual cases should be done according to the serologic profile and the IBD-specific treatment,with particular emphasis in patients receiving immunosuppressive *** patients who have not contracted HBV,vaccination is indicated to accomplish protective *** in immunosuppressed patients,however,is a challenging issue and several strategies for primary and revaccination have been *** risk of HBV reactivation in patients with IBD should be considered in both HBsAg-positive and HBsAg-negative/anti-HBc-positive patients,when immunosuppressive therapies are *** reactivation is preventable via the administration of prophylactic nucleot(s)ide analogues and should be the standard approach in HBsAg-positive ***-negative/anti-HBcpositive patients represent a non-homogeneous group and bear a significantly lower risk of HBV ***,serological and molecular monitoring is currently the recommended approach for anti-HBc *** HBV infection is rarely reported in IBD *** the present review,we outline the problems associated with HBV infection in patients with IBD and present updated evidence for their management.

关键词： Inflammatory bowel diseases   Viral infections   Opportunistic infections   Standard of care   Crohn’s disease   Ulcerative colitis  

摘要： Over the past decades,the treatment of inflammatory bowel diseases(IBD)has become more targeted,anticipating the use of immune-modifying therapies at an earlier *** top-down approach has been correlated with favorable short and long-term outcomes,but it has also brought with it concerns regarding potential infectious *** large IBD population treated with immunemodifying therapies,especially if combined,has an increased risk of severe infections,including opportunistic infections that are sustained by viral,bacterial,parasitic,and fungal *** infections have emerged as a focal safety concern in patients with IBD,representing a challenge for the clinician:they are often difficult to diagnose and are associated with significant morbidity and *** first step is to improve effective preventive strategies,such as applying vaccination protocols,adopt adequate prophylaxis and educate patients about potential risk *** viral infections in immunosuppressed patients may present atypical signs and symptoms,the challenges for the gastroenterologist are to suspect,recognize and diagnose such *** treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’*** practical review supports this standard of care to improve knowledge in this subject area.

关键词： 四磨汤口服液   专家共识   慢性胃肠疾病   术后肠胃功能康复  

摘要： 四磨汤口服液成方收录于明代《痘疹金镜录》,具有顺气降逆、消积止痛的功效,临床常用于中老年气滞、食积证,以及腹部手术后促进肠胃功能的恢复。为进一步规范和指导四磨汤口服液的临床应用,经中华中医药学会立项,由中国中医科学院西苑医院脾胃病研究所牵头,承担《四磨汤口服液用于慢性胃肠疾病治疗及腹部手术后肠胃功能康复的专家共识》的制定工作,共识研究工作于2018年8月启动,于2020年7月由中华中医药学会正式发布。共识从总论、内科、外科及安全性四个方面就四磨汤口服液临床应用中存在的问题进行说明,希望对临床合理使用四磨汤口服液提供一定的参考。

关键词： 功能性消化不良   肠易激综合征   胃食管反流病   无先兆偏头痛   横断面研究  

摘要： 背景:既往研究发现胃肠疾病患者头痛的发生率较高,而偏头痛患者常伴有胃肠道症状。了解疾病之间的关联可为其机制的研究和治疗提供新思路。目的:探索胃食管反流病(GERD)、功能性消化不良(FD)和肠易激综合征(IBS)与无先兆偏头痛(MWoA)的共患情况以及相关危险因素。方法:采用随机分层抽样的方法对陕西省2696名成年农村居民进行问卷调查,依据ICHD-Ⅲβ诊断标准、蒙特利尔标准、罗马Ⅳ标准分别诊断MWoA、GERD、FD和IBS,计算单病患病率以及与MWoA的重叠患病率,比较MWoA组与非MWoA组之间GERD、FD和IBS的患病率,并分析各个疾病的相关危险因素。结果:本研究共收集有效问卷2423份,GERD、FD、IBS的患病率分别为12.5%、15.6%、6.9%,MWoA的患病率为8.8%。MWoA组GERD(30.5%对10.7%)、FD(37.1%对13.5%)、IBS(27.2%对4.9%)的患病率均高于非MWoA组(P均<0.001)。多因素分析显示,女性、高血压、运动系统慢性损伤疾病史均与GERD、FD、IBS以及MWoA的患病呈正相关。结论:GERD、FD和IBS与MWoA之间存在一定的关联。

关键词： 肛肠疾病   孕产妇   危险因素  

摘要： 目的了解宁夏地区孕产妇肛肠疾病患病现状和其危险因素。方法采用分层整群随机抽样的方法,在宁夏地区5个城市中各抽取1家三级医院妇产科开展调查,在2018年6月-2019年6月期间,抽取孕产妇1 023例进行问卷调查(包括基本信息、妊娠情况、肛肠疾病情况、生活方式及心理情况等)和体格检查(包括肛门检查、直肠指检及肛肠镜检查)。采用SPSS 18.0统计软件进行统计分析,对影响孕产妇肛肠疾病患病率相关因素进行Logistic回归分析。结果 1 023例孕产妇中,肛肠疾病633例,患病率61.88%;宁夏地区不同居住地、民族、年龄、妊娠次数、孕周、饮食习惯、蔬菜水果摄入频率、焦虑状态及抑郁状态孕产妇肛肠疾病患病率比较,差异均有统计学意义(均P<0.05);不同吸烟、饮酒及文化程度孕产妇肛肠疾病患病率比较,差异均无统计学意义(均P>0.05)。多因素非条件Logistic回归分析结果显示:年龄2630岁、居住于城镇、妊娠次数≥3次、孕周≥28周、产后、喜辛辣油炸肉类食物、偶尔摄入蔬菜水果、经常焦虑及经常抑郁是宁夏地区孕产妇肛肠疾病患病的危险因素。结论宁夏地区孕产妇肛肠疾病的患病率为61.88%,其主要危险因素为居住于城镇、妊娠次数、孕周、年龄、喜辛辣油炸肉类食物、摄入蔬菜水果少及经常焦虑抑郁。

关键词： 肛肠疾病   术后恢复   控便能力   提肛运动  

摘要： 探讨提肛运动对肛肠疾病患者术后恢复控便能力的影响。方法:本组研究一共纳入82例患者作为研究对象,研究的时间范围控制在2018年12月-2020年12月,从这一时间段内本院收治的肛肠疾病患者中随机抽取82例。入组患者均接受手术治疗,将患者随机分组后实施不同的术后护理,分为两组,每组患者41例。其中常规护理组实施常规术后护理,提肛运动组联合引导患者参与提肛运动。结果:护理前提肛运动组控便能力评分为(1.49±0.12)分,低于常规护理组的(1.52±0.13)分,但检验后证实差异不明显,(P>0.05)。护理后常规护理组的控便能力评分为(0.47±0.04)分,高于提肛运动组的(0.12±0.03)分,且检验后证实数据组间差异显著,(P<0.05)。结论:肛肠疾病患者术后恢复中开展提肛运动可以更好的增强其控便能力。

关键词： 升督平木法   慢性盆腔疼痛综合征   顽固性便秘   脊神经源性肛肠疾病   名医经验  

摘要： 脊神经源性肛肠疾病包含了慢性盆腔疼痛综合征、成人顽固性便秘等疾病,“升督平木”法是从督脉功能及循行特点出发,结合脊神经生理病理而立。督阳不升,阳气阻遏,不能濡养经脉血络,加之湿热重浊,易阻滞下焦,此类患者多属督阳不升,湿热阻滞证,治法上以通达督阳为治疗总则,辅以祛湿通络等法,运用升督平木汤加减治疗。顽固性便秘患者重用白术加升麻、槟榔、枳壳、瓜蒌皮等健脾畅气机,盆腔痛患者予苍术、黄柏、秦艽、桃仁等行气止痛化瘀,旨在调和阴阳、平衡脏腑、和畅枢机,为肛肠疑难杂病探索新思路。

关键词： 肛肠疾病   术后感染   病原菌分布   耐药性  

摘要： 为探究肛肠疾病术后感染的病原菌分布和耐药性分析,选取我院行肛肠手术治疗并合并术后感染103例患者的临床资料,分析其术后感染的病原菌分布和耐药性。结果显示,菌株鉴定分析出203株病原菌,其中,革兰阳性菌78株(38.42%),革兰阴性菌125株(61.58%),病原菌种类和分离率之间存在显著性差异(P<0.05);金黄色葡萄球菌对青霉素、头孢唑林、环丙沙星、庆大霉素的耐药性较高,表皮葡萄球菌对青霉素、氨苄西林、环丙沙星、头孢唑林的耐药性较高,粪肠球菌对青霉素、环丙沙星、庆大霉素的耐药效果相似,对利福平、利奈唑胺较为敏感。肺炎克雷伯菌等阴性菌对氨苄西林、氨曲南的耐药性较高,对阿米卡星较为敏感。结果表明,革兰阴性菌是肛肠疾病患者术后较为多见的病原菌,临床治疗过程中,可根据病原菌的分布状态、抗菌药耐药性综合分析,予以有效的抗菌药物进行针对性治疗,降低术后感染率、耐药菌等不良事件的发生,为临床上合理用药,术后感染的预防提供更为广泛的治疗依据。