目的总结直肠神经内分泌肿瘤(RNEN)的临床诊断和治疗方法。 方法回顾性分析2009年1月至2013年12月期间南京中医药大学附属医院(江苏省中医院)收治的16例RNEN患者的临床资料。 结果16例患者均顺利完成手术,手术时间30~120 min,平均50 min;术中出血量10~80 mL,平均55 mL;均无手术死亡,术中均未见严重并发症发生。术后住院时间10~35 d,平均17 d。手术创面均一期愈合,均顺利出院。术后所有患者均获访,随访时间为2个月~5年,中位随访时间为20个月。随访期间所有患者均未见复发或转移,无死亡病例。 结论RNEN发病隐匿,具有恶性潜能,且常无特异性临床表现,故应加深对该病的认识,及时对就诊患者进行全面检查,做到早发现、早诊断及早治疗,且治疗后应对患者进行严密随访。
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.