81例结肠脾曲综合征的诊断与外科治疗  

Diagnosis and surgical treatment of syndrome of splenic flexure of colon in eighty-one patients

作　　者：杨维良[1] 张好刚[1] 张东伟[1] 王震[1] 刘阳[1] 

机构地区：[1]哈尔滨医科大学附属第二医院普外科,黑龙江哈尔滨150086

出　　处：《中国现代普通外科进展》2009年第10期833-836,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:总结结肠脾曲综合征(SSFC)的诊断与外科手术治疗。方法:对1989年1月—2008年12月收治的81例SSFC患者的临床资料进行回顾性分析。结果:本组患者以反复发作性腹痛、腹胀及便秘并顽固性不全结肠梗阻为主要临床表现。X线钡剂灌肠造影显示,结肠脾曲均较肝曲高7cm以上,迂曲成角<45°,并横结肠冗长。行结肠脾曲松解术2例和结肠脾曲侧侧吻合术3例,近期效果尚好,远期(6个月～2年)效果不良;76例采用较彻底手术,包括近段结肠大部切除14例、结肠次全切除术20例、全结肠切除术42例,术后均痊愈。结论:根据临床特点和钡剂灌肠造影,可以明确诊断SSFC,应积极手术治疗,以近段、次全、全结肠彻底切除效果最佳。Objective：To summarize diagnosis and surgical treatment of syndrome of splenic flexure of colon（SSFC） .Methods：The clinical data of SSFC in 81 patients between Jan,1987 and Dec,2008 were analysed retrospectively.Results：The main clinical manifestations were repeated abdominal pain,abdominal distension,constipation and chronic incomplete colon obstruction.X-ray barium enema showed that splenic flexure of colon was 7 cm higher than hepatic flexure of colon.The angle of splenic flexure of colon was less than 45 °.Two patients underwent release of splenic flexure of colon and 3 patients accepted side-to-side anastomosis of splenic flexure of colon which were suitable to old,weak and emergent patients.The effects of these methods were well shorthy after operation,but not in long term（6 months to 2 years） .As to the rest 76 patients,thorough operation were done：subtotal resection of proximal segment colon（14 patients） ,subtotal resection of colon（20 patients） and total resection of colon（42 patients） .Conclusion：The diagnosis of SSFC is depended on clinical manifestations and barium enema.Thorough surgical treatment is the best method including proximal part resection,subtotal resection and total resection of colon.

关 键 词：结肠脾曲综合征 诊断 外科手术 

分 类 号：R656.9[医药卫生—外科学]