我国结直肠外科良性疾病外科治疗现状和注意问题  

Current status and attention problems of surgical treatment of benign diseases in colorectal surgery in China

作　　者：刘宝华 刘沂 Liu Baohua;Liu Yi(Department of General Surgery,Daping Hospital,Army Medical University,Chongqing 400042,China;Department of Information,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院普通外科,重庆400042 [2]陆军军医大学大坪医院信息科,重庆400042

出　　处：《腹部外科》2020年第6期409-412,共4页Journal of Abdominal Surgery

摘　　要：此文就我国结直肠外科良性疾病的诊疗进展做一述评,重点阐述慢性便秘、炎症性肠病、直肠阴道瘘、直肠脱垂、结直肠损伤的外科治疗现状和存在的问题。慢性便秘的全结肠切除术和次全结肠切除术治疗结肠慢传输型便秘有较好疗效,出口梗阻型便秘的各种手术均有一定疗效,选择手术治疗和手术方式时应慎重。炎症性肠病中的溃疡性结肠炎的手术指征为发生了并发症和内科治疗无效者;手术方式为全结直肠切除加回肠储袋肛管吻合术。克罗恩病手术指征为穿孔、梗阻等并发症。直肠阴道瘘是根据瘘口位置决定手术方式。直肠脱垂的手术适应证为相对较重的Ⅱ度或Ⅲ度直肠脱垂及复发性直肠脱垂;手术方式分为经腹的各种直肠悬吊术和经会阴的直肠部分切除术。结肠损伤手术方式有一期修补术和结肠造口术。肛管直肠损伤根据损伤部位选择不同手术方式。This article reviews the progress of diagnosis and treatment of benign colorectal diseases in China,focusing on the status quo and problems of surgical treatment of chronic constipation,inflammatory bowel disease,rectovaginal fistula,rectal prolapse and colorectal injury.Total colectomy and subtotal colectomy for chronic constipation have good efficacy in the treatment of colonic slow transit constipation,and various operations for outlet obstruction constipation have certain efficacy,so it is necessary to be careful in the selection of operation and operation mode.The operative indications of ulcerative colitis in inflammatory diseases were complications and medical treatment failed.The surgical method was total colorectal resection and anastomosis of anal canal with ileal pouch.The operative indications of Crohn′s disease are perforation,obstruction and other complications.Rectovaginal fistula is a surgical procedure based on the location of the fistula.Rectal prolapse of vitreoretinal surgery for relatively heavyⅡdegrees orⅢrectal prolapse and recurrent rectal prolapse.The methods of operation are divided into various kinds of rectal suspensions through abdominal surgery and perineal partial rectal excision.The methods of operation for colonic injury include one-stage repair and colostomy.Different surgical methods were selected for anorectal injury according to the site of injury.

关 键 词：慢性便秘 炎症性肠病 直肠阴道瘘 直肠脱垂 结直肠损伤 

分 类 号：R65[医药卫生—外科学]