【摘要】 目的 探讨结肠慢传输型便秘合理的手术治疗方式。方法 回顾性分析1998年7月至2007年7月实施手术的28例患者临床资料,其中5例行结肠全切除术,12例行选择性1/3结肠切除术,11例行选择性2/3结肠切除术，观察分析3种手术的治疗效果。结果 28例患者手术总有效率82%,结肠全切除术无复发, 选择性1/3结肠切除术复发率明显高于选择性2/3结肠切除术。结论 结肠全切除术、选择性1/3结肠切除术和2/3结肠切除术3种术式对治疗STC均有满意的疗效,但结肠全切除术后患者腹泻发生率高,应根据患者的具体病情选择相应的术式。
【关键词】 慢传输型便秘;手术
The study of surgical treatment for colon slow transit constipation
Wen xigang, Luo jinbo, Yan li. Department of General Surgery, Zhongshan Hospital of Hubei Province, Wuhan 430033, China
[Abstract] Objective To investigate the reasonable surgical Methods in the treatment of colonic slow transit constipation(STC). Methods The clinical data of 28 patients with intractable colonic STC undergoing surgical treatment from July 1998 to July 2007 were retrospectively reviewed. Five of them underwent total colectomy, 12 underwent onethird colectomy, and 11 underwent twothird colectomy. Results The total efficiency of the three kinds of operation was 82%. There was no recurrence of constipation in the cases underwent total colectomy, and the cases performed onethird colectomy had a highter recurrence rate of constipation than the cases underwent twothird colectomy. Conclusion The effectiveness of three kinds of surgical modality for STC is satisfactory, but the rate of diarrhea was high in the cases undergoing total colectomy. The surgical modality must be selected according the conditions of patients with STC.
[Key words] Slow transit constipation; Surgical procedure
慢传输型便秘(slow transit constipation,STC)是1986年由Proton和LennardJoners提出,临床指以便秘、结肠通过时间延长和对纤维素、缓泻剂治疗反应差为特征,伴有腹胀腹痛、烦躁易怒、忧虑、失眠等一系列症状。结肠切除术治疗STC已广泛应用于临床，并取得了一定的疗效，手术方式很多，各有优缺点[1]。但尚无治疗标准规范不同程度的STC采取相适应的结肠切除术式。本研究旨在探讨合适长度的结肠切除对STC的临床综合征的改善作用。
1 资料与方法
1.1 一般资料 1998年7月至2007年7月湖北省中山医院普外科收治28例STC患者,男10例，女18例;年龄最小24岁，最大84岁，平均56.6岁;病程最短6年，最长30年。本组病例严格掌握手术适应证：⑴排便困难，粪便干结，排便时间间隔>3 d。⑵便意淡漠，需用泻剂和灌肠协助排便。无肠激惹综合征。⑶患者经排便造影、结肠传输实验及钡剂灌肠确诊。⑷气钡双重造影示结肠无张力。⑸除外肠腔内外
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