摘要
目的探讨慢传输性便秘（ＳＴＣ）的手术指征、手术治疗效果及可能的发病因素。方法收集我院近年来手术治疗的１７例ＳＴＣ患者的临床资料，分析其病例特点、手术方式及预后。结果本组患者大便次数每４～１４天１次，所有患者均有长期服用泻剂史。８２４％的患者伴有出口性便秘（ＯＯＣ），结肠传输试验均延长，５０％有性激素异常。病理研究发现，肌间丛嗜银性神经细胞减少，轴突空泡变性。所有患者术后恢复良好，３例术后出现粘连性肠梗阻，１例５年后有排出困难。结论结肠切除术是治疗ＳＴＣ的有效方法，但应同时处理存在的ＯＯＣ盆底变化（直肠内脱垂、子宫脱垂后倒、盆底下降及盆底疝）。
Objective To explore the operative indications,prognosis,and possible pathogenic factors of slow transit constipation(STC). Methods 17 cases with STC who had undergone colectomy were analysed. Results Bowel movement frequency was once per 4 to 14 days in all of the patients,who had had long term laxative abuse.Delayed colonic transit was demonstrated in all patients,82 4% of them were accompanied by outlet obstructive constipation (OOC) and 50% showed abnormal sex hormones.Reduced numbers of argyrophilic neurons and vacuolar degeneration of axons were demonstrated at the myenteric plexus pathologically. Three patients had adhensive ileus postoperatively and one patient suffered from difficult evacuation again 5 years after the operation.Conclusions Colectomy is highly effective in alleviating symptoms in patients with STC,and pelvic floor disorder of OOC should be treated simultaneously.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第2期91-92,共2页
Chinese Journal of Surgery
