摘要

在67名16岁或16岁之前开始出现症状的克罗恩病儿童中，已经确定了长期预后。平均随访时间为15.0年(1.5-47年)。每个五年期确诊的儿童数量没有增加。几乎所有患者在就诊时都有胃肠道症状，但在某些病例中，只有在仔细询问后才会出现这些症状。仅有4名儿童出现生长迟缓。21%的儿童在发病时或研究期间患有弥漫性小肠疾病，发病率和死亡率高，给治疗带来重大问题。他们通常接受药物治疗以抑制疾病活动，外科干预仅限于切除局部狭窄形成。远端回肠+/-右结肠疾病的结果与成人相似。结肠疾病患者(27%)接受了药物治疗，但83%的患者需要在平均间隔仅4年(范围0-9年)后进行手术切除。生长失败发生在21名儿童(身高和体重低于第三百分位)，其中11名儿童有一段时间的追赶生长; 10 after resection (ileal +/- right colon resected, eight; colonic resection, two) and one after medical treatment. Ten have permanent growth and height retardation, of whom four had diffuse small bowel disease and three had early recurrence after surgical resection. Nine children have died during the period of review, of whom six had diffuse small bowel disease. Despite the high morbidity, 38 of the 58 survivors are now well with no evidence of recurrent disease. A further 14 are well, but with radiological evidence of residual (colon, three; diffuse small bowel, eight) or recurrent (three) disease. Only six have symptomatic disease at present.