特发性便秘197例临床分析  

Surgical treatment of idiopathic constipation:a clinical analysis of 197 cases

作　　者：黄显凯[1] 张胜本[1] 张连阳[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所普外科

出　　处：《中华普通外科杂志》1999年第4期254-256,共3页Chinese Journal of General Surgery

摘　　要：目的探讨特发性便秘的治疗。方法手术治疗特发性便秘１９７例，其中慢传输型便秘２４例，出口梗阻型便秘１７３例，后者包括直肠内套叠７５例，直肠粘膜脱垂５７例，耻骨直肠肌痉挛２５例，直肠前膨出１６例。慢传输型便秘２４例，行结肠次全切除术２０例，行左半结肠切除术４例。采用硬化剂注射治疗直肠粘膜脱垂５４例、直肠内套叠２３例。直肠粘膜缩缝术治疗直肠粘膜脱垂３例。改良式Ｏｒ’ｓ直肠悬吊治疗直肠内套叠５２例，其中加行乙状结肠切除术３１例，加行结肠次全切除术５例，女患者加行子宫悬吊３２例。直肠前膨出行直肠修补１６例。耻骨直肠肌痉挛２５例均采用生物反馈治疗。结果慢传输型便秘痊愈１００％（２４／２４）。直肠粘膜脱垂痊愈７９％（４５／５７），好转２０％（１１／５７），无效２％（１／５７）。直肠内套叠痊愈６３％（４７／７５），好转２９％（２２／７５），无效８％（６／７５）。直肠前膨出痊愈６９％（１１／１６），好转３１％（５／１６）。耻骨直肠肌痉挛好转７２％（１８／２５），无效２８％（７／２５）。结论慢传输型便秘手术治疗效果较好，而出口梗阻型便秘的疗效还有待进一步提高。Objective To investigate treatment for idiopathic constipation. MethodsA retrospective analysis was made on 197 cases of idiopathic constipation undergoing surgery,including 24 cases of slow transit constipation,173 cases of outlet obstructive constipation.The latter included 75 cases of internal rectal prolapse,57 cases of rectomucosal prolapse,25 cases of puborectal spasm,and 16 cases of anterior rectocele.Of the 24 cases of slow transit constipation.20 received subtotal colectomy,4 left colectomy.54 cases of rectomucoal prolapse and 23 of internal rectal prolapse were treated by sclerossant injection.Rectomucosal infolding suture was carried out in 3 cases of rectomucosal prolapse.52 cases of internal rectal prolapse received modified Orr's rectopexy, added by sigmoidectomy in 31 cases,subtotal colectomy in 5 cases,and womb pexis in 32 cases.16 cases of anterior rectocele were treated by rectal repair.Biofeedback therapy was applied to 25 cases of puborectal spasm. ResultsBZ100% (24/24) of the cases with slow transit constipation was cured.In the cases of rectomucosal prolapse,79% (45/57) was cured,63% (47/75) of internal rectal prolapse was cured,69% (11/16) of the cases of anterior rectocele was cured.Of the cases of puborectal spasm,the symptom of 72% (18/25) was improved.G2 Conclusion The prognosis of slow transit constipation is excellent,while that of outlet obstructive constipation remains to be improved.

关 键 词：便秘 外科手术 疗效 

分 类 号：R656.905[医药卫生—外科学]