两种不同联合术式治疗重度功能性便秘临床分析  

Clinical analysis of two different combined operative methods in the treatment of severe functional constipation

作　　者：王玉宏[1] 赵飞[1] 岳峰[1] 董永杰[1] 李玉梅[1] 张贵堂[1] 冯运章[1] 

机构地区：[1]邯郸市中心医院普外二科,056001

出　　处：《结直肠肛门外科》2016年第3期271-274,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的比较开腹、腹腔镜次全结肠切除术分别联合改良Duhamel术治疗重度功能性便秘临床疗效。方法随机抽取我院2011年2月至2014年8月行开腹次全结肠切除术+改良Duhamel术(标记为开腹组)、腹腔镜次全结肠切除术+改良Duhamel术(标记为腹腔镜组)重度功能性便秘患者各30例,比较两组手术效果、术后并发症及手术前后便秘症状总评分。结果两组平均手术时间[(284.1±26.2)VS(227.3±20.6)]min、术中出血量[(141.4±65.5)VS(340.5±100.7)]ml、术后排气时间[(4.0±0.8)VS(5.5±0.7)]d、术后1个月便秘症状总评分[(3.0±0.7)VS(5.6±1.2)]分比较差异有统计学意义(P<0.01)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论开腹、腹腔镜次全结肠切除术及其联合改良Duhamel术均能明显改善重症功能性便秘症状,开腹手术时间明显更短,而手助腹腔镜手术具有微创、术后恢复快、住院时间短优点。Objective To compare the clinical effects of respective combination of open surgery and laparoscopic subtotal colectomy with modified Duhamel surgery in the treatment of severe functional constipation. Methods 30 patients with severe functional constipation who underwent open subtotal colectomy combined with modified Duhamel surgery （marked as the open group） and another 30 patients with severe functional constipation who underwent hand assisted laparoscopic subtotal colectomy combined with modified Duhamel surgery （marked as the laparoscopic group） in our hospital from from February 2011 to August 2014 were randomly selected. The surgical effects, postoperative complications and the total scores of constipation symptoms before and after surgery were compared between the two groups. Results The differences in average operative time [（284.1±26.2）VS （227.3±20.6） ] mix, intraoperative blood loss [ （141.4±65.5）VS（340.5±100.7） ]ml, postoperative exhaust time [ （4.0±0.8） VS（5.5±0.7）]d and the total scores of constipation symptoms in 1 month after surgery [（3.0±0.7）VS（5.6±1.2）] between the two groups were statistically significant （P 〈 0.01 ）. There was no statistically significant difference in the incidence of postoperative complications between the 2 groups （P 〉 0.05）. Conclusion Open surgery and laparoscopic subtotal colectomy and their respective combination with modified Duhamel surgery can significantly improve the symptoms of severe functional constipation. The time of open surgery is significantly shorter while hand assisted laparoscopic surgery has advantages of minimally invasive, rapid postoperative recovery and shorter hospital stay.

关 键 词：次全结肠切除术 腹腔镜 开腹 重度功能性便秘 

分 类 号：R656.9[医药卫生—外科学]