頁籤選單縮合
題 名 | 藥物於預防克隆氏症者手術後復發=Medical Prophylaxis of Postoperative Recurrence in Patients with Crohn's Disease |
---|---|
作 者 | 賴怡珊; 童玟津; | 書刊名 | 藥學雜誌 |
卷 期 | 32:2=127 2016.06[民105.06] |
頁 次 | 頁109-114 |
分類號 | 415.5 |
關鍵詞 | 克隆氏症; 術後復發; Crohn's disease; Prophylaxis; Postoperative recurrent; |
語 文 | 中文(Chinese) |
中文摘要 | 克隆氏症為一種發炎性的腸道疾病,臨床特點是會一直反覆性發作,約有46%患者 在病程10年之後仍需進行手術切除腸道,但手術無法治癒疾病,術後復發的機率仍是相 當高。於術後安排患者定期做內視鏡檢查,可以預測及追蹤其復發的狀況,而對於具有 復發傾向的患者,可以使用 nitroimidazole 類抗生素、5-aminosalicylate acid (5-ASA)、 azathioprine/6-mercaptopurine (6-MP) 或 anti-TNF α等藥物來降低復發的風險。其中, nitroimidazole 類抗生素已被廣泛地運用為基礎預防藥物,5-ASA 提供安全但較弱的預 防功效,azathioprine/6-MP 可以降低復發率但同時也提高不良反應發生的風險,而 anti- TNF α 則為這之中最有效的藥品,但價格昂貴且服用方式較不便利。醫療人員應了解 患者復發的危險因子,並藉由定期的內視鏡檢查來評估患者復發的風險,進而選擇出最 具成本效益的藥物來降低患者復發的機率。 |
英文摘要 | Crohn's disease is a type of inflammatory bowel disease with the characteristic of frequent recurrences. Almost 46% patients undergo intestinal resection within 10-years disease course. Unfortunately, the surgery for crohn's disease is not curative. The recurrence rate is still high even after the surgery. Endoscopy can help clinicians to predict and observe the recurrence early. Once the recurrence was observed in endoscope, nitroimidazole antibiotic, 5-aminosalicylate acid (5-ASA) , anzathioprine/6-mercaptopurine (6-MP) and anti-TNFα can be used to reduce the recurrence rate. The use of nitroimidazole antibiotic was already widespread. 5-ASA offered a safety but modest benefit in preventing relapses. Azathioprine/6-MP was effective but may increase the adverse events leading to patient withdrawal. Last, anti-TNF α was the most effective strategy for postoperative prophylaxis, whereas the cost and not convenient to take should be considered. The benefit, safety and even the cost should be balanced when planning the strategies. Evaluating the patients' risk of recurrence combined with the endoscopic screening may help to tailor intervention. |
本系統中英文摘要資訊取自各篇刊載內容。