顽固结肠慢传输性便秘16例的临床分析  

TREATMENT ANALYSIS OF SIXTEEN CASES OF COLONIC SLOW TRANSIT CONSTIPATION

作　　者：彭洪云[1] 辛林[1] 邬林泉[1] 方路[1] 温晓茂 

机构地区：[1]江西医学院第二附属医院,南昌330006 [2]江西新建县人民医院

出　　处：《大肠肛门病外科杂志》2001年第1期22-24,共3页Journal of Coloproctological Surgery

摘　　要：目的 :探讨顽固性结肠慢传输性便秘的合理治疗方法。方法 :总结顽固性结肠慢传输性便秘患者经 X线钡灌肠以及排粪造影检查 ,结合临床特征而决定手术切除冗长结肠 12例 ,4例非手术治疗 ,其中冗长横结肠 4例 ,冗长乙状结肠 12例 ,伴直肠前凸 3例 ,重度直肠膨出 ,盆底下降 1例 ,4例患者中 3例经肛修复 ,1例经腹修复 ,重建盆底。 3例乙状结肠冗长扭转行急诊手术。结果 :11例患者恢复良好 ;有 1例高龄患者仅行扭转乙状结肠复位而于术后 10 d死亡 ,随访 3年 ,1例有肠粘连症状 ,1例切口感染。 4例非手术治疗症状未缓解。结论 :顽固性结肠慢传输性便秘冗长结肠是其原因之一 ,需早期手术切除 ,伴有直肠前凸 ,盆底下降可一期手术修复。如待急诊肠扭转再手术 ,则危险较大 ,甚至危及生命。而非手术治疗症状不得缓解 。Objective: To explore valid treatment of severe colonic slow transit constipation Methods:The paper retrospectively analyzed and summed up 12 cases with resection of long and tedious colon used for severe clolnic slow transit constipation confirmed by Barium enema examination and defecography and clinical features,and 4 cases with nonoperative management Of all patients,long and tedious transverse colon in 4 cases,long and tedious sigmoid colon in 12 cases,including 3 rectocele,1 severe rectum swelling combined with pelvic floor decline Depending on folding methods by transrectal repair of anterior rectal wall used for 3 rectocele,by transabdomimal repair of anterir rectal wall accompanied with reconstruction of pelivec floor used for 1 severe rectocele,3 cases of patients combined with sigmoid colon volvulus were treated with emergency operation Results:Results showed that 11 patients turned better 1 elder patients having only surgeical detorsion of acute sigmoid volvulus died in 10 days postoperatively The follow up study ranging from 6 months to 3 years revealed that bowel adhesions was found in one case and operative wound infection in one case Symptoms of 4 cases with nonoperative management are not rellieved Conclusion:The early operation is a good one to treat severe colonic slow transit constipation caused by long and tedious colon one stage operation were particularly recommended for the patients with rectocele and pelvic floor decline because the mortality of the patients with emergency operation was higher Nonoperative management can't relieve symptoms but may cause drug dependance

关 键 词：冗长结肠 便秘 外科手术 

分 类 号：R656.9[医药卫生—外科学]