结肠慢传输型便秘的诊断和外科手术治疗体会

目的：探讨结肠慢传输型便秘的诊断与手术治疗。方法：回顾性分析我院2001至2007年治疗的结肠慢传输型便秘25例患者的治疗资料。其中行保留回盲部的结肠次全切除术8例，行切除回盲部的回肠乙状结肠下端吻合术9例，行全结肠切除术5例，行结肠部分切除术的3例。结果：病理检查结果示结肠肌间神经节细胞减少变性或缺如。盲肠结肠吻合术后患者大便次数2～4次／日，回肠乙状结肠下端吻合术后患者大便次数3～5次／日，全结肠切除术后为5～8次／日，结肠部分切除术后为1—2次／1～2天。结论：结肠次全切除术是治疗结肠慢传输型便秘的有效方法，保留回盲部的结肠次全切除术与切除回盲部回肠乙状结肠下端吻合术疗效无明显差异。

Diagnosis and Treatment of Colon Slow Transit Constipation

Objective ： To investigate the diagnosis and treatment of the colon slow transit constipation. Method： The treatment information of 25 cases with colon slow transit constipation in our hospital from 2001 to 2007 was analyzed retrospectively. In which 8 cases with colon subtotal colectomy that retain the ileocecum; 9 cases with subtotal colectomy with ileosigmoidal anastomosis; 5 cases with total colectomy; and 3 cases with the partial colectomy were done . Results： Pathological examination showed the colon muscle ganglion cells were reduced and degenerate or absent. The patients after subtotal colectomy with the cecum-colon anastomosis have stool frequency of 2 -4 times/day; after subtotal colectomy with ileosigmoidal anastomosis, the stool frequency of 3 -5 times/day; after the total colectomy, of 5 -8 times/day; after the partial colectomy, of 1 -2 times/1 -2 days. Conclusion： The subtotal co- lectomy is aneffective treatment for the colon slow transit constipation. Between the subtotal colectomy with ileoeecal junction and the subtotal colectomy with ileosigmoidal anastomosis without ileocecal junction, there was no significant difference.