改良单孔腹腔镜手术治疗混合型便秘的临床效果  

Clinical Effect of Improved Single-port Surgery for Mixed Constipation

作　　者：张东平 杨士民 马军宏 郑章强 赵悦 吕鹏 于向阳 ZHANG Dong-ping;YANG Shimin;MA Jun-hong(Graduate School of Tianjin University of Traditional Chinese Medicine,Tianjin(301617),China)

机构地区：[1]天津中医药大学研究生院,天津301617

出　　处：《中国中西医结合外科杂志》2022年第4期512-516,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:研究腹腔镜结肠次全切除术及直肠悬吊术治疗混合型便秘患者的临床效果。方法:总结分析2019年12月5日—2021年4月1日行结肠次全切除及直肠悬吊术治疗便秘的7例患者的临床资料,使用Longo出口梗阻便秘症状评分、Wexner便秘评分、CSS慢性便秘严重程度评分,Pac-qol便秘患者生存质量评分评价患者手术前后便秘改善情况。结果:所有患者无术后出血、吻合口瘘、肠梗阻、肛门失禁等并发症出现,患者手术时长(303.6±19.9)min,出血量(42.9±11.7)mL。手术前后Longo评分分别为(21.0±2.4)分、(4.5±0.8)分,Wexner评分分别为(13.1±0.7)分、(2.0±0.5)分,CSS评分分别为(16.1±0.5)分、(2.7±0.7)分,Pac-qol评分分别为(109.0±5.7)分、(37.6±1.4)分,手术后的上述评分均低于术前,差异有统计学意义(P<0.05)。患者出口梗阻症状较前明显改善,术后排便时间缩短,少见肛门坠胀感。大便性状也有所改善,随时间推移逐渐恢复至正常排便。结论:腹腔镜结肠次全切除术联合直肠悬吊术解决了混合型便秘的病因,治疗便秘效果确切,并发症少,患者满意度高,值得临床推广应用。Objective To retrospectively analyze the clinical effect and value of improved single-port laparoscopic subtotal colectomy and rectal suspension for patients with mixed constipation.Methods The clinical data of 7 patients with mixed constipation who underwent subtotal colon resection and rectal suspension for the treatment of constipation were analyzed.Longo outlet obstruction constipation symptom score,Wexner constipation score,constipation severity score and patient assessment of constipation quality of life questionnaire(Pac-qol)were used to evaluate the improvement of constipation before and after surgery.Results All the operations were completed successfully without postoperative complications,such as postoperative bleeding,anastomotic fistula,intestinal obstruction and incontinence.The operative time was(303.6±19.9)min,the blood loss was(42.9±11.7)mL.The Wexner constipation score,Longo constipation score and symptom severity score were(2.0±0.5)points,(4.5±0.8)points and(2.7±0.7)points,Pal-qol was(37.6±1.4)which were significantly lower than preoperative scores(P<0.05).Conclusion Laparoscopic subtotal colectomy combined with rectal suspension for mixed constipation is a safe and feasible procedure with good cosmetic satisfaction and excellent short-time effects.It is worthy of clinical promotion.

关 键 词：改良单孔腹腔镜手术 混合型便秘 结肠次全切除 直肠悬吊 

分 类 号：R656.9[医药卫生—外科学]