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排序方式: 共有1833条查询结果,搜索用时 171 毫秒
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目的:探讨成人结肠冗长症的诊断与围手术期处理经验,提高对该病的诊治水平。方法:回顾性分析42例成人结肠冗长症的临床资料,并作了随访观察。结果:32例患者(75.7%)有顽固性便秘,18例患者(42.9%)存在反复不完全肠梗阻,16例患者(38.1%)便秘与腹泻交替出现,以便秘为主。39例经X线钡剂灌肠透视确诊。急诊手术3例,择期手术39例。41例(97.6%)病理检查于镜下可见典型改变。42例均行不同长度的肠段切除,4例加行乙状结肠固定术。术后随访率为83.3%(35/42),28例症状消失,4例仍有症状,保守治疗有效果,3例再次手术,术后症状消失。结论:典型的病史和X线钡剂灌肠可确诊成人结肠冗长症,外科手术是治疗本病的最终有效措施。 相似文献
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Long-term results of the antegrade continent enema procedure for constipation in adults 总被引:3,自引:0,他引:3
OBJECTIVE: The aim of this study was to evaluate the long-term results of the Antegrade Continent Enema (ACE) procedure for treating severe constipation in adults. METHODS: Over 10 years 37 ACE conduits were created in 32 patients (median age 35 years, 26 women) with constipation caused by slow transit, obstructed defaecation or both. Conduits were created from the appendix (n = 20, 54%), ileum (n = 10, 27%), neoappendix caecostomy (n = 5, 14%) or colon (n = 2, 5%). Clinical records were retrospectively reviewed to determine outcome. RESULTS: After a median follow up of 36 (range 13-140) months, 28 (88%) required at least one further procedure on a primary conduit, including reversal in 19 (59%). Five patients had a second conduit fashioned, two successfully. Conduit type and constipation cause did not significantly influence the rates of ACE reversal or major revision. Ileal conduits were associated with fewer minor revision procedures for stenosis (1 in 7 patients) than appendix conduits (21 in 20 patients). There was one (3%) serious complication. Satisfactory ACE function was ultimately achieved in 47% of patients, at last follow up. After ACE reversal, 9 (28%) patients underwent formation of an end stoma and 3 patients had a colectomy. CONCLUSIONS: Revision procedures are common, but approximately half of patients can expect satisfactory long-term ACE function. ACE conduit reversal does not preclude subsequent alternative surgical strategies to treat this difficult condition. 相似文献
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W. E. Whitehead G. Bassotti O. Palsson E. Taub E. C. Cook III D. A. Drossman 《Digestive and liver disease》2003,35(11):229-783
BACKGROUND AND AIMS: Functional gastrointestinal disorders are diagnosed by the presence of a characteristic set of symptoms. Aims of this study were to validate the Rome symptom criteria by factor analysis and to determine whether symptoms cluster in the same way in different cultures. METHODS: One thousand forty-one gastroenterology clinic patients in the US (response rate 53%) and 228 family members accompanying clinic patients in Italy (84%) completed a previously validated symptom questionnaire. Factor analysis identified clusters of symptoms which are highly correlated with each other, and these were compared to the Rome diagnostic criteria. RESULTS: In the US, 13 factors were identified. The irritable bowel factor was composed of three core symptoms corresponding to the Rome II classification system. Two dyspepsia factors were identified which correspond to the ulcer- and motility-like subtypes proposed in the Rome I classification system. All symptoms of constipation formed a single cluster as proposed in the Rome II classification system. Symptom clusters in the US agreed well with symptom clusters identified in Italian subjects. CONCLUSIONS: Empirically derived symptom clusters agree in most respects with the Rome II classification system and support their validity. These symptom clusters are independent of cultural differences in diet and behaviour. 相似文献
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目的探讨护理干预对蛛网膜下腔出血患者便秘的影响。方法采用随机分组,实验组采取护理干预措施,对照组采取神经内科护理常规。结果2组患者排便情况、便秘相关反应比较差异显著。结论护理干预减少蛛网膜下腔出血患者便秘的发生,提高抢救成功率。 相似文献
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Anin vitro electrophysiological study of the colon from patients with idiopathic chronic constipation 总被引:2,自引:0,他引:2
Charles H. V. Hoyle BSc PhD Michael A. Kamm MD John E. Lennard-Jones MD Geoffrey Burnstock PhD DSc 《Clinical autonomic research》1992,2(5):327-333
Preparations of the circular muscle layer from the sigmoid colon resected from patients with idiopathic chronic constipation were compared, at an electrophysiological level using the sucrose-gap technique, with preparations of the same region of the intestine resected from patients with rectal carcinoma. Non-adrenergic, non-cholinergic inhibitory neuromuscular transmission, represented by inhibitory junction potentials, was present in preparations from both groups. However, the inhibitory response in preparations from constipated patients had a slower or longer time-course than in those from cancer patients. Also, rebound activity following inhibitory transmission was observed in 34% of preparations from constipated patients but was observed in 67% of preparations from cancer patients. Preparations from both groups displayed the same patterns of spontaneous activity and the same proportion of each group was quiescent. The threshold for generation of action potentials and the passive resistance of the smooth muscle membrane were the same in both groups. However, quiescent preparations from constipated patients were less likely to discharge trains of action potentials when the smooth muscle membrane was depolarized than were preparations from cancer patients. These changes in transmission processes and excitability in tissue from constipated patients are discussed in relation to altered states of colonic motility found in people with idiopathic chronic constipation. 相似文献
10.
R. Fotter 《European radiology》1998,8(2):248-258
The aims of this review article are to present epidemiology, important definitions, clinical considerations, and etiologic
and pathogenetic aspects of constipation in infants and children. Anatomy, physiology, and pathophysiology of the the anorectum
are described. Special attention is given to the indications for diagnostic imaging, imaging techniques, and imaging findings
with different causes of constipation. Other diagnostic modalities, such as anorectal manometry, electromyography, and biopsy
techniques are briefly discussed. The central question as to whether diagnostic imaging is needed for the diagnostic workup
of infants and children suffering from constipation can be answered affirmatively. Especially the combination of barium enema
or defecography and anorectal manometry allows definition of those infants and children who do not need biopsy and surgery
for Hirschsprung's disease. The special role of defecography in this context is underlined.
Received 16 May 1997; Revision received 5 August 1997; Accepted 6 August 1997 相似文献