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Gastroenterology:注射自体脂肪组织治疗CD相关肛周瘘

2019-05-30 MedSci MedSci原创

注射新收集的自体脂肪组织是安全的,并且57%的患者可以完全治愈肛周瘘

肛周瘘在克罗恩病(CD)患者中很常见。注射培养的自体和异体脂肪组织干细胞已被证明可以治愈CD相关的瘘管,但上述治疗手段既费时又昂贵。近日研究人员考察了新收集的自体脂肪组织注射对CD患者肛周瘘的效果。

研究招募21例CD患者,将新收集的自体脂肪组织注射到复杂的肛周瘘中。主要终点为最后一次注射后6个月瘘口完全愈合(无出院症状,会阴无明显外瘘口,直肠数字检查无内瘘口)。研究人员对临床表现完全愈合的括约肌间和经括约肌瘘患者进行盆腔磁共振成像,以确定瘘道的分辨率。6周后瘘口未完全愈合和复发的患者给予额外注射。

最后一次脂肪组织注射6个月后,12例患者(57%)瘘完全愈合。3名患者(14%)停止了瘘管分泌,1名患者(5%)报告分泌减少。10例经括约肌或括约肌间瘘患者中,9例患者的磁共振成像显示完全的瘘消退,其余患者的股薄瘘明显减少。在12例完全瘘愈合的患者中,9例(43%)需要1次注射,2例(10%)需要2次注射,1例(5%)需要3次注射。主要不良反应是手术后几天的程序性疼痛。2例患者出现小脓肿,1例尿潴留,1例抽脂时出现轻微出血。

研究认为,注射新收集的自体脂肪组织是安全的,并且57%的患者可以完全治愈肛周瘘。

原始出处:


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    2019-10-11 许安
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