横结肠脾曲综合征致顽固性不完全肠梗阻的诊治分析

目的提高对脾曲综合征的认识和诊治水平。方法对28例脾曲综合征的资料进行了回顾性分析。结果中老年女性患者居多，均表现为周期性的不完全性肠梗阻，钡剂灌肠可发现横结肠脾曲过高、成角或扭转，横结肠冗长胀大积粪。所有病例均经长期非手术处理，有多次肠梗阻急诊入院经过。行脾曲松解12例，迂曲的脾曲切除10例，脾曲松解加横结肠部分切除4例，脾曲肝曲松解加横结肠切除2例。行结肠部分切除者6例行端端吻合，10例行侧侧吻合。随访3个月发现食欲好转，体重增加，1例术后早期出现肠梗阻，结肠镜发现吻合口水肿，予以消炎消肿治疗好转。结论顽固性的脾曲综合征往往需要手术治疗，手术简单，疗效较好。

The Diagnosis and Treatment of Splenic Flexure Syndrome Which Caused Severe Incomplete Colon Construction

Objective To improve the cognition of Splenic Flexure Syndrome(SFS) and how to diagnose and treat this syndrome. Methods Twenty-eight cases were analysed retrospectively. Results Most were female of middle-age or old-age. The symptom was periodic and incomplete colonic obstruction. According to clusis of Barium, it was found that the splenic flexure of colon was high, angulate or twisting, and transverse colon was tediously long, distend and full of stool. All cases were given long-term non-operation treatment, and all had been charged into emergency for many times because of acute obstruction. 12 cases were given brisement of splenic flexure, 10 cases were given resection of splenic flexure, 4 cases were given brisement of splenic flexure and partly resection of transverse colon, 2 cases were given brisement of splenic and hepatic flexure and resection of transverse colon. 6 cases were given tip-to-tip anastomosis and 10 cases side-to-side anastomosis of colon. It was found that the appetite improved and body weight increased after 3 months. Colon obstruction happened in 1 case after operation because of edema of stoma, and recovered after short-term non-operation treatment. Conclusions It was recommended that operation was necessary to cure intractable SFS, and operation was simple and effectable.