成人结肠冗长症34例外科治疗体会  

Adult Colon Disease 34 Cases were Long Surgical Treatment Experience

作　　者：崔智文 谭嘉梦 秦建华 张化礼 王闽全[3] 

机构地区：[1]伊犁州新华医院,新疆伊宁835000 [2]伊犁州奎屯医院,新疆奎屯833200 [3]新疆医科大学第二附属医院,新疆乌鲁木齐830000

出　　处：《亚太传统医药》2012年第11期112-114,共3页Asia-Pacific Traditional Medicine

摘　　要：目的:探讨成人结肠冗长症的诊断及鉴别诊断、外科手术治疗方法,以进一步提高对该病的认识和诊治水平。方法:回顾性分析34例结肠冗长症患者的临床资料,结合文献进行分析。结果:34患者均有便秘、长期服用泻剂病史,8例因乙状结肠扭转行急诊手术复位,3～6个月有6例二期手术。34例均在充分准备下择期手术:Ⅰ型27例,行右半、左半结肠或乙状结肠、横结肠单节段冗长结肠扩大切除;Ⅱ型6例,行升-横结肠、横-降结肠、降-乙状结肠扩大切除;Ⅲ型仅1例,保留一半横结肠的结肠次全切除。所有患者经手术治疗2周至3个月后排便1～3次/d,体重增加,摆脱长期使用泻剂,生活质量及体质明显改善。全组均无吻合口瘘、严重腹泻等发生。结论:结肠冗长症外科治疗切除结肠的范围应行扩大趋势,避免复发;对全结肠冗长慎行全结肠切除,避免产生术后严重腹泻,故合理地扩大切除是避免复发和防范并发症的关键。Objective:To study the colon disease of adult long diagnosis and differential diagnosis and surgical treatment methods,and to further improve the understanding of the disease and treatment level.Methods:Retrospective analysis in January 1995 from January 2010 to 34 cases were treated colon in patients long clinical data and combining with document analysis.Results:All patients and constipation,long-term laxative history,8 cases of the sigmoid colon reverse do emergency operation reset,3~6 months in 6 cases were invited to second phase of the operation.34 cases were fully prepared for elective surgery in under: Ⅰ type and 27 cases,left or right,do the colon,HengJieChang single segment the sigmoid colon long colon expand excision;Ⅱ type in 6,line up-HengJieChang,cross-descending colon,fall-the sigmoid colon expand excision;Ⅲ type only one case,reservation half HengJieChang colon sub-total.All of the patients by surgery two weeks to March 1 to 3 times back then/d,weight gain,get rid of the long-term use of cathartic,quality of life,and physical obviously improved.The group were no anastomosis,serious diarrhea occurred.Conclusion:The colon disease surgical treatment of the colorectal resection long range should expand trend line,avoid recurrence;For all the colon lengthy careful travel all the colon resection,avoid to produce postoperative severe diarrhea.So reasonable expand resection is to avoid recurrence and prevent complications of the key.

关 键 词：结肠冗长症 便秘 诊断 外科手术治疗 

分 类 号：R574.62[医药卫生—消化系统]