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find Author "李悠然" 2 results
  • 保留括约肌挂线引流术联合英夫利昔单抗治疗肛周瘘管型克罗恩病的短期临床疗效

    目的 总结保留括约肌挂线引流术联合英夫利昔单抗(infliximab,IFX)治疗肛周瘘管型克罗恩病(Crohn disease,CD)的短期临床疗效。 方法 回顾性分析江苏省中医院肛肠科于 2010 年 3 月至 2011 年 6 月期间收治的接受保留括约肌挂线引流术联合 IFX 治疗的 20 例肛周瘘管型 CD 患者的临床资料,治疗方案为降阶梯治疗。在第 0、2 及 6 周分别给予 5 mg/kg IFX 静脉注射诱导治疗,随后给予每 8 周 1 次、共 3 次的 IFX 维持治疗(5 mg/kg),共计 6 次。于治疗前和第 0、6 及 30 周治疗后评估克罗恩病活动指数(CDAI)、肛周克罗恩病活动指数(PCDAI)、治疗效果及瘘管闭合情况,并开展实验室检测。 结果 ① CDAI 和 PCDAI:与治疗前比较,第 0、6 及 30 周的 CDAI 和 PCDAI 均较低(P<0.05)。② 瘘管闭合:第 0 周时,18 例瘘管部分闭合,2 例无效;第6 周时,16 例瘘管完全闭合,4 例部分闭合;第 30 周时,16 例瘘管完全闭合,1 例部分闭合,3 例复发。③ 实验室检查:与治疗前比较,第 0、6 及 30 周的 C-反应蛋白(CRP)水平、红细胞沉降率(ESR)、血小板计数、中性粒细胞百分比及白细胞计数均较低(P<0.05),第 6 周和第 30 周的血红蛋白水平较高(P<0.05)。④ 不良反应:治疗过程中 3 例次发生不良反应。 结论 保留括约肌挂线引流术联合 IFX 降阶梯治疗对肛周瘘管型 CD 有效。

    Release date:2017-11-22 03:58 Export PDF Favorites Scan
  • A preliminary clinical efficacy analysis of local injection of high concentration of glucose when removing setons of perianal fistulizing in Crohn’s disease

    Objective To explore the effect of local injection of high concentration of glucose when removing setons of perianal fistulizing in Crohn’s disease (CD). Methods Thirty cases of CD combined with anal fistula admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from August 2015 to July 2017 were collected prospectively, 12 cases were divided into experimental group and 18 cases were divided into control group. Cases of the experimental group received demolition of drainage seton+IFX+local injection of high concentration of glucose treatment, cases of the control group received the drainage setons removing+IFX only. Before treatment, and at 6, 14, 22, and 30 weeks after IFX treatment, the laboratory indicators of the 2 groups were detected, and BMI, Crohn’s diseaseactivity index (CDAI), perianal disease activity index (PDAI), and clinical efficacy were evaluated. Results Therewas no significant difference on the group effect and interaction of group and time (P>0.05), but time (P<0.05). Both in the experimental group and the control group, compared with before treatment group, the counts of WBC and platelet, levels of C reaction protein (CRP) and erythrocyte sedimentation rate (ESR), CDAI, and PDAI at 6 months after IFX therapy decreased and maintained at the latter period, but the level of hemoglobin (Hb) and BMI increased at 6 weeks after IFX therapy and maintained at the latter period. On the clinical effect, there was no significant difference at the time points of 14, 22, and 30 weeks of IFX therapy (P>0.05). Conclusion The treatment of local injection of high concentration of glucose when removing setons has not shown any positive effect to CD combined with anal fistula, this conclusion needs to be further studied.

    Release date:2018-06-15 10:49 Export PDF Favorites Scan
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