便秘患儿的胃肠传输时间测定及其意义

目的　初步测定正常中国儿童的胃肠传输时间并探讨胃肠传输时间对小儿便秘的病因、诊断和分型的意义。方法　研究对象分为对照组和便秘组。对照组 3 3例 ,男 2 1例 ,女 12例 ,平均年龄 5岁。便秘组 2 5例 ,男 15例 ,女 10例 ,平均年龄 7岁 ,均符合Benninga的便秘诊断标准。应用简化的不透X线标记物追踪法 ,即多次口服标记物一次摄片法测定正常和便秘儿童的全胃肠传输时间 (Totalgastrointestinaltransittime,TGITT)和节段性结肠传输时间 ,包括 :右半结肠传输时间 (Rightcolonictransittime ,RCTT) ;左半结肠传输时间 (Leftcolonictransittime ,LCTT)和直肠乙状结肠传输时间(Rectosigmoidcolonictransittime ,RSTT) ;部分患儿联合应用X线排便造影 ,探讨便秘的诊断和分型 ;结果　正常儿童的TGITT ,RCTT ,LCTT和RSTT分别为 2 8 7± 7 7小时、7 5± 3 2小时、6 5± 3 8小时和 13 4± 5 6小时 ;便秘组的TGITT ,LCTT和RSTT较对照组明显延长 (92 2± 5 5 5小时vs 2 8 7± 7 7小时 ,P <0 0 0 1;16 9± 12 6小时vs 6 5± 3 8小时 ,P <0 0 1;和 61 5± 2 9 0小时vs 13 4± 5 6小时 ,P <0 0 0 1)。RCTT无显著变化。X线排便造影显示直肠前突、会阴下降综合征和耻骨直肠肌痉挛综合征各 1例。结论　首次     

Long-Term Results of Subtotal Colectomy with Antiperistaltic Cecoproctostomy

Purpose. To evaluate the clinical role of subtotal colectomy with cecorectal anastomosis (CRA) and its postoperative results, based on our surgical experience. Methods. We retrospectively analyzed 26 patients who underwent subtotal colectomy with CRA during an 8-year period (1992–1999) in our university hospital. The indications for CRA were intractable constipation, colon tumors, diverticulitis, Crohns disease, and postactinic colitis. CRA was performed using a new technique of end-to-end antiperistaltic anastomosis. Postoperative and late complications, and functional results, defined as the number of bowel movements per day and quality of life, were evaluated. Results. None of the patients experienced postoperative or late complications. Two patients died from progression of colon cancer. The mean follow-up period was 4.5 years (range 1–8 years). By 1 month after surgery, 58% of the patients were passing frequent bowel movements, and by 1 year after surgery, only 23% of the patients were passing frequent bowel movements. The last follow-up revealed a mean 1.7 bowel movements per day, and only one patient was taking medication for diarrhea. All patients were satisfied with the results of their surgery and reported that their quality of life was good or improved, and even very good in six cases. Conclusions. Subtotal colectomy with our new CRA technique is appropriate for treating inflammatory diseases of the bowel, colon tumors, and intractable constipation in selected patients.     

The assessment of constipation in monosymptomatic primary nocturnal enuresis

Objective: Nocturnal enuresis and constipation are common pediatric problems. The aim of this study was to assess the incidence of constipation in children with or without monosymptomatic primary nocturnal enuresis.Methods: The study included 5350 children, ages 5–19 years, who were surveyed to detect the incidence of nocturnal enuresis. Of those surveyed, 679 (12.7%) had primary nocturnal enuresis. All children were questioned by mail with a standard form that addressed their micturition and defecation habits. The children those who had primary nocturnal enuresis were invited to the Pediatric Urology Section of the University Hospital. Of those 679 children, 125 kept that invitation. All 125 of those children underwent an abdominal ultrasound. Also, these children had serum creatinine levels drawn and plain abdominal films taken.Results: Constipation, defined as less than 3 bowel movements per week, was seen in 48 of 679 children with nocturnal enuresis (7.06%). Of those 4671 children without nocturnal enuresis, only 68 (1.45%) had constipation. The difference in constipation between the two groups was statistically significant (z = –9.251; p = 0.000). Of note, 10 of the 125 children (8%), evaluated at the hospital, had constipation. None of the children had an abnormal neurologic examination. Finally, faecal loading was detected on the plain films of 8 of the 125 children evaluated, 7 of who had constipation. The sensitivity of grading plain films for faecal loading to denote constipation in this population was 87.5%.Conclusions: Children with primary nocturnal enuresis should be thoroughly assessed for coexisting constipation.     

P物质和血管活性肠肽在慢传输型便秘大鼠肠壁内的变化和可复性研究

目的观察便秘模型大鼠小肠和结肠P物质(SP)和血管活性肠肽(VIP)的变化及自然恢复情况,了解大黄所致便秘的可恢复性。方法Wistar大鼠60只,按照完全随机的方法分为便秘组、恢复组、对照组各20只,便秘组和恢复组给予大黄建立便秘大鼠模型,恢复组于建立模型完成后任其自然恢复6周。以放射免疫方法和免疫组织化学方法测定比较各组大鼠小肠和结肠VIP和SP的变化。结果与对照组比较,便秘组和恢复组大鼠的小肠、结肠SP含量均显著降低(P<0.05),恢复组小肠SP含量显著高于便秘组(P<0.05),恢复组结肠SP含量与便秘组比较无差别(P>0.05)。便秘组小肠和结肠VIP表达较对照组明显降低(P<0.05);恢复组VIP表达较便秘组高(P<0.05),但低于对照组(P<0.05)。结论长期应用大黄等蒽醌类泻剂对肠道神经系统有明显的损害作用,小肠和结肠SP含量降低,VIP反应性降低,停用大黄恢复性饲养6周后肠道神经递质VIP和SP部分恢复。     

腹部按摩在早产儿便秘中的临床观察

目的探讨腹部按摩在早产儿便秘中的效果。方法选择29例早产儿随机分成实验组15例和对照组14例，实验组采取腹部抚触按摩排便法，对照组采用开塞露通便法。结果实验组早产儿第一次排便平均时间比对照组明显提前，按摩效果显著。结论腹部按摩法可有效促进早产儿排便，提高舒适度，减少并发症。     

微生态制剂和乳果糖协同治疗儿童功能性便秘临床分析

目的:探讨微生态制剂(培菲康)和乳果糖协同治疗小儿功能性便秘的效果.方法:101例功能性便秘患儿随机分为两组,治疗组61例,对照组40例. 对照组改善不良饮食习惯;治疗组在其基础上加服培菲康和乳果糖口服溶液.结果:治疗组总有效率为90.16%,对照组总有效率为52.50%,治疗组疗效优于对照组(P＜0.05),且远期复发率较对照组低.结论:培菲康和乳果糖协同治疗小儿功能性便秘疗效显著.     

老年患者便秘情况及其影响因素研究

目的了解老年人便秘的影响因素。方法选择我院愿意参加调查的所有老年患者进行分组研究。结果本研究实际调查老年人114例,便秘的总患病率为39%,男性人群便秘患病率为34%,女性人群患病率为46%。结论老年人便秘与多种因素有关,需综合治疗才能有效减少便秘或改善便秘症状。     

耳穴贴压及腹部按摩对肿瘤化疗患者排便的影响

目的 探讨耳穴贴压及腹部按摩对肿瘤化疗患者排便的影响.方法 选择肿瘤科185例化疗患者,随机分为甲组:耳穴贴压+腹部按摩组,65例;乙组:腹部按摩组,62例;丙组:常规护理组,58例.比较3组的排便情况.结果 首次排便时间>72 h甲组10例,乙组22例,丙组31例,差异有统计学意义(P<0.01);首次排便情况甲组明显优于丙组和乙组.结论 采用耳穴贴压及腹部按摩有利于改善肿瘤化疗患者的排便情况.     

不同文化程度老年人便秘知识获得及相关因素调查

①目的探讨不同文化程度老年人便秘的相关因素。②方法采用便秘罗马二诊断标准对国内26省2412名老年人进行问卷调查。③结果文化程度高的老年人较文化程度低的老年人获得便秘有关知识状况好；老年便秘的发生受多种因素影响，存在显著性差异（P〈0．01）；有36．48％的老年人存在便秘问题。④结论应加强对老年人的健康教育，尤其是面对文化程度相对低的老年群体。