炎癥性腸病診治進(jìn)展(6)
五、Crohn病的治療選擇
1.輕癥 口服氨基水楊酸鹽(結(jié)腸病變)；也可用布地奈德(19mg/天，適用于回盲部病變，無全身并發(fā)癥者)；甲硝唑?qū)Ω刂懿〖胺乐剐g(shù)后吻合口復(fù)發(fā)有效。長(zhǎng)期服用劑量>10mg/kg時(shí)，可發(fā)生周圍性神經(jīng)病變。
2.中度 口服皮質(zhì)類固醇；硫唑嘌呤或6-mp(激素依賴性患者，難治性或肛周瘺管患者)
3.重癥 靜脈質(zhì)類固醇；靜脈環(huán)孢霉素(難治性、瘺管或重癥均有效，長(zhǎng)期療效尚不定)
4.緩解期 口服美沙拉命(對(duì)口服氨基水楊酸鹽好轉(zhuǎn)者有效，可預(yù)防手術(shù)后復(fù)發(fā))。
參考文獻(xiàn)
1.潘國宗。 潰瘍性結(jié)腸炎的治療原則 消化系疾病新概念 1998;1(3):1-3.
, 百拇醫(yī)藥
2.歐陽欽。 我國炎性腸病研究的概況及展望 中華消化雜志 1993;13(6):313.
3.Posenberg IH. 序三 見鄭家駒主編：炎癥性腸病 第一版 上�？萍汲霭嫔� 1998.
4.Carpenter HA, Talley NJ. The imporatance of clinicopathological correlation in the diagnosis of inflammatory conditions of the colon: histological patterns with clinical implications. Am J Gastroenterol 2000;95(4):878-896.
5.鄭家駒。 炎癥性腸病的定義與分類。 中華消化雜志 1987:7(3):158.
, 百拇醫(yī)藥 6.Hanauer SB. Inflammatory bowel disease. In: Bennett JC, Plum F (eds). Cecil Textbook of Medicine. W>B> Saunders Company. Philadelphia 1996;707-715.
7.Kormbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults. Am J Gastroenterol 1998;92(2):204-211.
8.D'Haens G, Geboes K, Peeters M, et al. Patchy cecal inflammation associated with distal ulcerative colitis: A prospective endoscopic study. Am J Gastroenterol 1997;92:1275-9.
, 百拇醫(yī)藥
9.Kornbluth A, Salomon P, Sachar DB. Crohn's disease. In: Sleisenger MH, Fordtran JS (eds). Gastrointestinal disease. W.B.Saunders Company. Philadelphia 1993;1270-1304.
10.Schreiber, Nikolaus S, Raedler A, Stricture formation in Crohn's disease. Res clin forum. 1998;20(1):87-98.
11.Gilberts ECAM, Greestein AJ, Katsel P, Harpaz N, Greenstein RJ. Molecular evidence for two forms of Crohn's disease. Proc Natl Acad Sci 1994;91:12721-12724.
, 百拇醫(yī)藥
12.鄭家駒、諸行琦、賈黎明、史肖華。Crohn病不典型臨床表現(xiàn)與有關(guān)因素。中國醫(yī)師雜志 2000;2(3):142-144.
13.潘國宗、陳敏章、劉彤華，等�？寺∈喜-60例分析。中華內(nèi)科雜志 1980;428-432.
14.鄭家駒、諸行琦、賈黎明。臨床表現(xiàn)不典型Crohn病內(nèi)鏡與病理組織學(xué)特點(diǎn)。中華消化內(nèi)鏡雜志(待發(fā)表).
15.Peria As, Heuwissen SGH. Diagnosis of the first attack of colitis. Res Clin Forum 1998;20(1):67-76.
16.Gasche C, Moser G, Turetschek K, Schober E, Moeschl P, Oberhuber G, Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease. Gut 1999;44:112-117.
, 百拇醫(yī)藥
17.Arndt JW, Grootscholten MI, van Hogezand RA, Griffioen G, Lamers CBHW, Pauwels EKJ. Inflammatory bowel disease activity assessment using Technetium-99m-HMPAO leukocytes. Dig Dis Sci 1997;42(2):387-393.
18.黃大剛，鐘捷，李彪，張晨莉，夏璐，江石湖。99mTc-hIg G 在炎癥性腸病診斷與隨訪中的臨床應(yīng)用。胃腸病學(xué) 1999;4(3):147-149.
19.Nielson OH, Vainer B, Madsen SM, Seidelin JB, Heegaard NHH. Established and emerging biological activity markers of inflammatory bowel disease. Am J Gastroenterol 2000;95(2):359-367., 百拇醫(yī)藥
1.輕癥 口服氨基水楊酸鹽(結(jié)腸病變)；也可用布地奈德(19mg/天，適用于回盲部病變，無全身并發(fā)癥者)；甲硝唑?qū)Ω刂懿〖胺乐剐g(shù)后吻合口復(fù)發(fā)有效。長(zhǎng)期服用劑量>10mg/kg時(shí)，可發(fā)生周圍性神經(jīng)病變。
2.中度 口服皮質(zhì)類固醇；硫唑嘌呤或6-mp(激素依賴性患者，難治性或肛周瘺管患者)
3.重癥 靜脈質(zhì)類固醇；靜脈環(huán)孢霉素(難治性、瘺管或重癥均有效，長(zhǎng)期療效尚不定)
4.緩解期 口服美沙拉命(對(duì)口服氨基水楊酸鹽好轉(zhuǎn)者有效，可預(yù)防手術(shù)后復(fù)發(fā))。
參考文獻(xiàn)
1.潘國宗。 潰瘍性結(jié)腸炎的治療原則 消化系疾病新概念 1998;1(3):1-3.
, 百拇醫(yī)藥
2.歐陽欽。 我國炎性腸病研究的概況及展望 中華消化雜志 1993;13(6):313.
3.Posenberg IH. 序三 見鄭家駒主編：炎癥性腸病 第一版 上�？萍汲霭嫔� 1998.
4.Carpenter HA, Talley NJ. The imporatance of clinicopathological correlation in the diagnosis of inflammatory conditions of the colon: histological patterns with clinical implications. Am J Gastroenterol 2000;95(4):878-896.
5.鄭家駒。 炎癥性腸病的定義與分類。 中華消化雜志 1987:7(3):158.
, 百拇醫(yī)藥 6.Hanauer SB. Inflammatory bowel disease. In: Bennett JC, Plum F (eds). Cecil Textbook of Medicine. W>B> Saunders Company. Philadelphia 1996;707-715.
7.Kormbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults. Am J Gastroenterol 1998;92(2):204-211.
8.D'Haens G, Geboes K, Peeters M, et al. Patchy cecal inflammation associated with distal ulcerative colitis: A prospective endoscopic study. Am J Gastroenterol 1997;92:1275-9.
, 百拇醫(yī)藥
9.Kornbluth A, Salomon P, Sachar DB. Crohn's disease. In: Sleisenger MH, Fordtran JS (eds). Gastrointestinal disease. W.B.Saunders Company. Philadelphia 1993;1270-1304.
10.Schreiber, Nikolaus S, Raedler A, Stricture formation in Crohn's disease. Res clin forum. 1998;20(1):87-98.
11.Gilberts ECAM, Greestein AJ, Katsel P, Harpaz N, Greenstein RJ. Molecular evidence for two forms of Crohn's disease. Proc Natl Acad Sci 1994;91:12721-12724.
, 百拇醫(yī)藥
12.鄭家駒、諸行琦、賈黎明、史肖華。Crohn病不典型臨床表現(xiàn)與有關(guān)因素。中國醫(yī)師雜志 2000;2(3):142-144.
13.潘國宗、陳敏章、劉彤華，等�？寺∈喜-60例分析。中華內(nèi)科雜志 1980;428-432.
14.鄭家駒、諸行琦、賈黎明。臨床表現(xiàn)不典型Crohn病內(nèi)鏡與病理組織學(xué)特點(diǎn)。中華消化內(nèi)鏡雜志(待發(fā)表).
15.Peria As, Heuwissen SGH. Diagnosis of the first attack of colitis. Res Clin Forum 1998;20(1):67-76.
16.Gasche C, Moser G, Turetschek K, Schober E, Moeschl P, Oberhuber G, Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease. Gut 1999;44:112-117.
, 百拇醫(yī)藥
17.Arndt JW, Grootscholten MI, van Hogezand RA, Griffioen G, Lamers CBHW, Pauwels EKJ. Inflammatory bowel disease activity assessment using Technetium-99m-HMPAO leukocytes. Dig Dis Sci 1997;42(2):387-393.
18.黃大剛，鐘捷，李彪，張晨莉，夏璐，江石湖。99mTc-hIg G 在炎癥性腸病診斷與隨訪中的臨床應(yīng)用。胃腸病學(xué) 1999;4(3):147-149.
19.Nielson OH, Vainer B, Madsen SM, Seidelin JB, Heegaard NHH. Established and emerging biological activity markers of inflammatory bowel disease. Am J Gastroenterol 2000;95(2):359-367., 百拇醫(yī)藥
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