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Review Article

腹部克罗恩病手术中的抗TNF和术后并发症

卷 20, 期 13, 2019

页: [1339 - 1348] 页: 10

弟呕挨: 10.2174/1389450120666190404144048

价格: $65

摘要

背景：在过去的几十年中，抗肿瘤坏死因子（TNF）-α药物的生物疗法彻底改变了炎症性肠病的治疗方法。但是，在腹部手术前用抗TNF-α药物治疗的克罗恩病（CD）患者术后并发症的风险可能会增加。 目的：评估术前抗TNF-α治疗对术后并发症发生率的影响。 方法：对临床试验结果的结果进行了关键性评估，并对可用数据进行荟萃分析。 结果：基于先前报道的结果（包括荟萃分析），术前使用抗TNF-α药物适度增加了CD腹部手术后总体并发症，尤其是感染性并发症的风险。然而，先前的研究有一些局限性。他们中的大多数是回顾性研究，采用了不同的结果指标和相对较小的样本量的单中心试验。在回顾性研究中，未使用评估各种类型术后并发症的标准方案。先前研究中最严重的局限性是未考虑营养不良，使用皮质类固醇激素和术前败血症等多种混杂因素。 结论：在接受术前抗TNF-α治疗的患者中，CD腹部手术后总体并发症和感染性并发症的风险可能会略有增加。然而，本研究中回顾的先前报告存在局限性。为了严格评估手术前抗TNF-α治疗的风险，有必要进行具有标准化标准的大型前瞻性研究，以评估手术并发症并适当调整混杂变量。

关键词: 克罗恩病，手术，抗肿瘤坏死因子-α药物，抗TNF药物，生物制剂，术后并发症，感染性并发症，吻合口并发症。

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